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3915 Center Rd Brunswick OH 44212-3087 | |
| (330) 237-1544 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 3915 Center Rd, Brunswick, Ohio |
| Authorized Official Name and Position | Igor J. Skalsky (CEO/OWNER) |
| Authorized Official Contact | 3302731544 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3915 Center Rd Brunswick OH 44212-3087 Ph: (330) 237-1544 | 3915 Center Rd Brunswick OH 44212-3087 Ph: (330) 237-1544 |
| NPI Number | 1194179036 |
|---|---|
| Provider Enumeration Date | 04/18/2016 |
| Last Update Date | 04/18/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194179036 | NPI | - | NPPES |
| 30.016564 | Other | OH | OHIO LICENSE 30.016564 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 30.016564 (Ohio) | Primary |
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