| Icare Dental Llc | |
|
14865 Detroit Ave Lakewood OH 44107-3909 | |
| (216) 772-2310 | |
| Not Available |
| Full Name | Icare Dental Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 14865 Detroit Ave, Lakewood, Ohio |
| Authorized Official Name and Position | Rami Mouded (MANAGER) |
| Authorized Official Contact | 4404544530 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Icare Dental Llc 31088 Bellerive Ct Westlake OH 44145-1893 Ph: (440) 454-4530 | Icare Dental Llc 14865 Detroit Ave Lakewood OH 44107-3909 Ph: (216) 772-2310 |
| NPI Number | 1669242657 |
|---|---|
| Provider Enumeration Date | 01/02/2024 |
| Last Update Date | 05/30/2024 |
| Medicare PECOS PAC ID | 1951746783 |
|---|---|
| Medicare Enrollment ID | O20240301003120 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669242657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Rami Mouded |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1104167824 PECOS PAC ID: 8729465406 Enrollment ID: I20240301003252 |
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