| Western Reserve Periodontics, Inc | |
|
3609 Park East Dr #411 Beachwood OH 44122-4331 | |
| (216) 464-7338 | |
| Not Available |
| Full Name | Western Reserve Periodontics, Inc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 3609 Park East Dr, Beachwood, Ohio |
| Authorized Official Name and Position | Fredrick A Rosenberg (SECRETARY/TREASURER) |
| Authorized Official Contact | 2164648985 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Reserve Periodontics, Inc 3609 Park East Dr #411 Beachwood OH 44122-4331 Ph: (216) 464-7338 | Western Reserve Periodontics, Inc 3609 Park East Dr #411 Beachwood OH 44122-4331 Ph: (216) 464-7338 |
| NPI Number | 1699964759 |
|---|---|
| Provider Enumeration Date | 10/15/2007 |
| Last Update Date | 10/15/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699964759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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