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NPI Code Detail

MEDICARE: DRS. GROSS, MALCMACHER, THALER & ASSOCIATES, LLC

MEDICARE: DRS. GROSS, MALCMACHER, THALER & ASSOCIATES, LLC
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
11223G0001XGeneral Practice Dentistry30.014838OH

General Provider Information

NPI Number : 1033130380
Entity Type Code : Organization
Provider Name (Legal Business Name) : DRS. GROSS, MALCMACHER, THALER & ASSOCIATES, LLC
Provider Business Mailing Address
First Line : 34586 LAKE SHORE BLVD
Second Line :
City : EASTLAKE
State : OH
Zip : 44095-2002
Country : US
Telephone Number : 440-951-7856
Fax Number : 440-946-7878
Provider Business Practice Location Address
First Line : 34586 LAKE SHORE BLVD
Second Line :
City : EASTLAKE
State : OH
Zip : 44095-2002
Country : US
Telephone Number : 440-951-7856
Fax Number : 440-946-7878
Authorized Official
Title or Position : DOCTOR OWNER
Name : DR. JEFFREY GROSS
Credential : DDS,FAGD
Telephone Number : 440-951-7856
Provider Enumeration Date : 07/22/2006
Last Update Date : 05/26/2011

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Directions to “DRS. GROSS, MALCMACHER, THALER & ASSOCIATES, LLC ” Practice Location

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