| Marc R Greenbaum Dds Inc | |
|
18611 Detroit Ave Lakewood OH 44107 | |
| (216) 221-2210 | |
| (216) 226-8037 |
| Full Name | Marc R Greenbaum Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 18611 Detroit Ave, Lakewood, Ohio |
| Authorized Official Name and Position | Marc R Greenbaum (PRESIDENT) |
| Authorized Official Contact | 2162212210 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marc R Greenbaum Dds Inc 18611 Detroit Ave Lakewood OH 44107 Ph: (216) 221-2210 | Marc R Greenbaum Dds Inc 18611 Detroit Ave Lakewood OH 44107 Ph: (216) 221-2210 |
| NPI Number | 1811939564 |
|---|---|
| Provider Enumeration Date | 06/10/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811939564 | NPI | - | NPPES |
| 0455449 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 15147 (Ohio) | Primary |
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