MEDICARE: DR. WILLIAM FRANKLIN LAVIGNA 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	122300000X	Dentist	14847	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871584870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM FRANKLIN LAVIGNA DDS

Provider Business Mailing Address
First Line	:	11201 SHAKER BLVD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44104-3833
Country	:	US
Telephone Number	:	216-368-7238
Fax Number	:	216-791-8322

Provider Business Practice Location Address
First Line	:	11201 SHAKER BLVD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44104-3869
Country	:	US
Telephone Number	:	216-368-7238
Fax Number	:	216-791-8322

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

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	09/17/2007

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