| Northeast Ohio Center For Dental Sleep Medicine Llc | |
|
22901 Millcreek Blvd Suite #140 Beachwood OH 44122-5728 | |
| (216) 831-1170 | |
| Not Available |
| Full Name | Northeast Ohio Center For Dental Sleep Medicine Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 22901 Millcreek Blvd, Beachwood, Ohio |
| Authorized Official Name and Position | Douglas E Desatnik (PRESIDENT) |
| Authorized Official Contact | 2168311170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Ohio Center For Dental Sleep Medicine Llc 22901 Millcreek Blvd Suite #140 Beachwood OH 44122-5728 Ph: (216) 831-1170 | Northeast Ohio Center For Dental Sleep Medicine Llc 22901 Millcreek Blvd Suite #140 Beachwood OH 44122-5728 Ph: (216) 831-1170 |
| NPI Number | 1558801480 |
|---|---|
| Provider Enumeration Date | 02/25/2017 |
| Last Update Date | 11/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558801480 | NPI | - | NPPES |
| 1417269820 | Other | OH | UPIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | OH 30-023233 (Ohio) | Primary |
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