| Mentor Dental Arts Ronald L. Micchia Dds, Inc. | |
|
9140 Lakeshore Blvd Mentor OH 44060 | |
| (440) 257-3900 | |
| (440) 257-7070 |
| Full Name | Mentor Dental Arts Ronald L. Micchia Dds, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9140 Lakeshore Blvd, Mentor, Ohio |
| Authorized Official Name and Position | Ronald Micchia (DENTIST/CEO) |
| Authorized Official Contact | 4402573900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mentor Dental Arts Ronald L. Micchia Dds, Inc. 9140 Lakeshore Blvd Mentor OH 44060 Ph: (440) 257-3900 | Mentor Dental Arts Ronald L. Micchia Dds, Inc. 9140 Lakeshore Blvd Mentor OH 44060 Ph: (440) 257-3900 |
| NPI Number | 1578640066 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 10/21/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578640066 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 15919 (Ohio) | Primary |
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