MEDICARE: DR. DALIA THWEIB DDS

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	1223G0001X	General Practice Dentistry	30.026271	OH

General Provider Information

NPI Number	:	1831751858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DALIA THWEIB DDS

Provider Business Mailing Address
First Line	:	3377 KINGS MILL RUN
Second Line	:
City	:	ROCKY RIVER
State	:	OH
Zip	:	44116-3957
Country	:	US
Telephone Number	:	440-463-8489
Fax Number	:

Provider Business Practice Location Address
First Line	:	21245 LORAIN RD STE 100
Second Line	:
City	:	FAIRVIEW PARK
State	:	OH
Zip	:	44126-2140
Country	:	US
Telephone Number	:	440-331-0164
Fax Number	:

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

Provider Enumeration Date	:	06/29/2019
Last Update Date	:	11/15/2021

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