MEDICARE: DR. DANE JEFFERY GENTHER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207YS0123X	Facial Plastic Surgery Physician	35.133967	OH

General Provider Information

NPI Number	:	1013236819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANE JEFFERY GENTHER MD

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE
Second Line	:	A71
City	:	CLEVELAND
State	:	OH
Zip	:	44195
Country	:	US
Telephone Number	:	216-445-3729
Fax Number	:	216-445-9409

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE
Second Line	:	A71
City	:	CLEVELAND
State	:	OH
Zip	:	44195
Country	:	US
Telephone Number	:	216-445-3729
Fax Number	:	216-445-9409

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2010
Last Update Date	:	01/06/2025

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