| Elite Dentistry Center Llc | |
|
24300 Chagrin Blvd Suite 304 Beachwood OH 44122-5639 | |
| (216) 464-3200 | |
| (216) 464-3201 |
| Full Name | Elite Dentistry Center Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 24300 Chagrin Blvd, Beachwood, Ohio |
| Authorized Official Name and Position | Bogdan S Butriy (OWNER) |
| Authorized Official Contact | 2164643200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Dentistry Center Llc 24300 Chagrin Blvd Suite 304 Beachwood OH 44122-5639 Ph: (216) 464-3200 | Elite Dentistry Center Llc 24300 Chagrin Blvd Suite 304 Beachwood OH 44122-5639 Ph: (216) 464-3200 |
| NPI Number | 1700286853 |
|---|---|
| Provider Enumeration Date | 08/26/2014 |
| Last Update Date | 08/26/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700286853 | NPI | - | NPPES |
| 293757 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 30.022982 (Ohio) | Primary |
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