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18342 Bagley Rd Cleveland OH 44130-3411 | |
| (440) 274-5900 | |
| (440) 239-3102 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 18342 Bagley Rd, Cleveland, Ohio |
| Authorized Official Name and Position | John A Hudec (OWNER/PRESIDENT) |
| Authorized Official Contact | 2164855788 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3327 Broadview Rd Cleveland OH 44109-3360 Ph: (216) 485-5788 | 18342 Bagley Rd Cleveland OH 44130-3411 Ph: (440) 274-5900 |
| NPI Number | 1578861357 |
|---|---|
| Provider Enumeration Date | 03/03/2011 |
| Last Update Date | 10/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578861357 | NPI | - | NPPES |
| 3126012 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 30-015265 (Ohio) | Primary |
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