| Urban M. Picard Dds, Inc | |
|
15711 Madison Ave Suite #104 Lakewood OH 44107-5655 | |
| (216) 228-9000 | |
| (216) 228-8280 |
| Full Name | Urban M. Picard Dds, Inc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 15711 Madison Ave, Lakewood, Ohio |
| Authorized Official Name and Position | Urban M Picard (PRESIDENT) |
| Authorized Official Contact | 2162289000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Urban M. Picard Dds, Inc 15711 Madison Ave Suite #104 Lakewood OH 44107-5655 Ph: (216) 228-9000 | Urban M. Picard Dds, Inc 15711 Madison Ave Suite #104 Lakewood OH 44107-5655 Ph: (216) 228-9000 |
| NPI Number | 1356567606 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356567606 | NPI | - | NPPES |
| 0879581 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 30.017754 (Ohio) | Primary |
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