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NPI Code Detail

MEDICARE: CRANIOFACIAL IMAGING CENTER

MEDICARE: CRANIOFACIAL IMAGING CENTER
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
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry16067OH

General Provider Information

NPI Number : 1841372935
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRANIOFACIAL IMAGING CENTER
Provider Business Mailing Address
First Line : 10900 EUCLID AVE
Second Line : CASE SCHOOL OF DENTAL MEDICINE - 3RD FLOOR
City : CLEVELAND
State : OH
Zip : 44106-1712
Country : US
Telephone Number : 216-368-2674
Fax Number : 216-368-3204
Provider Business Practice Location Address
First Line : 10900 EUCLID AVE
Second Line : CASE SCHOOL OF DENTAL MEDICINE - 3RD FLOOR
City : CLEVELAND
State : OH
Zip : 44106-1712
Country : US
Telephone Number : 216-368-2674
Fax Number : 216-368-3204
Authorized Official
Title or Position : CHAIRMAN
Name : DR. MARK G HANS
Credential : DDS, MSD
Telephone Number : 216-368-4649
Provider Enumeration Date : 10/19/2006
Last Update Date : 08/22/2020

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10900 EUCLID AVE
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1205783933 — DAVID ANDRES SILVA
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1780767970 — DR. MASAHIRO HEIMA DDS, PHD
Practice Location Address:
10900 EUCLID AVE
CLEVELAND, OH
44106-1712
Practice Phone: 216-368-1379
Practice Fax:
1336278142 — MS. CONSTANCE CRIHFIELD CRNP
Practice Location Address:
10900 EUCLID AVE
CLEVELAND, OH
44106-1712
Practice Phone: 216-368-2761
Practice Fax: 216-368-8530
1265561534 — MS. MELISSA ANN HORN RN MSN CRNP
Practice Location Address:
10900 EUCLID AVE , FPB SCHOO OF NURSING
CLEVELAND, OH
44106-1712
Practice Phone: 216-368-6277
Practice Fax: 216-368-3542

Directions to “CRANIOFACIAL IMAGING CENTER ” Practice Location

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