| Rosewater Dental Associates, Inc. | |
|
2626 Lorain Ave Cleveland OH 44113-3415 | |
| (216) 861-2124 | |
| (216) 861-4025 |
| Full Name | Rosewater Dental Associates, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2626 Lorain Ave, Cleveland, Ohio |
| Authorized Official Name and Position | Richard A Kormos (PRESIDENT) |
| Authorized Official Contact | 2168612124 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rosewater Dental Associates, Inc. 2626 Lorain Ave Cleveland OH 44113-3415 Ph: (216) 861-2124 | Rosewater Dental Associates, Inc. 2626 Lorain Ave Cleveland OH 44113-3415 Ph: (216) 861-2124 |
| NPI Number | 1588788525 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 12/31/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588788525 | NPI | - | NPPES |
| 312263 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 30-18772 (Ohio) | Primary |
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