MEDICARE: DR NASSIF AND ASSOCIATES INC

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	19716	OH

General Provider Information

NPI Number	:	1982026688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR NASSIF AND ASSOCIATES INC

Provider Business Mailing Address
First Line	:	5507 MAYFIELD RD
Second Line	:
City	:	LYNDHURST
State	:	OH
Zip	:	44124-2913
Country	:	US
Telephone Number	:	440-473-3338
Fax Number	:	440-473-1988

Provider Business Practice Location Address
First Line	:	5507 MAYFIELD RD
Second Line	:
City	:	LYNDHURST
State	:	OH
Zip	:	44124-2913
Country	:	US
Telephone Number	:	440-473-3338
Fax Number	:	440-473-1988

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHRISTOPHER NASSIF
Credential	:	DDS
Telephone Number	:	440-473-3338

Provider Enumeration Date	:	01/15/2014
Last Update Date	:	09/21/2015

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