| Dr. Kates Premier Smiles Orthodontics Inc | |
|
16909 Chagrin Blvd Shaker Heights OH 44120-3725 | |
| (216) 691-9944 | |
| (216) 691-9949 |
| Full Name | Dr. Kates Premier Smiles Orthodontics Inc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 16909 Chagrin Blvd, Shaker Heights, Ohio |
| Authorized Official Name and Position | Dale A Kates (OWNER) |
| Authorized Official Contact | 2166919944 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Kates Premier Smiles Orthodontics Inc 16909 Chagrin Blvd Shaker Heights OH 44120-3725 Ph: (216) 691-9944 | Dr. Kates Premier Smiles Orthodontics Inc 16909 Chagrin Blvd Shaker Heights OH 44120-3725 Ph: (216) 691-9944 |
| NPI Number | 1265869150 |
|---|---|
| Provider Enumeration Date | 10/09/2013 |
| Last Update Date | 10/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265869150 | NPI | - | NPPES |
| 0064406 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 19830 (Ohio) | Primary |
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