Healthcare Provider Details
I. General information
NPI: 1285561845
Provider Name (Legal Business Name): SAMANTHA LEE SZABO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
37701 COLORADO AVE STE E
AVON OH
44011-2841
US
IV. Provider business mailing address
37701 COLORADO AVE STE E
AVON OH
44011-2841
US
V. Phone/Fax
- Phone: 440-934-2600
- Fax: 440-934-2602
- Phone: 440-934-2600
- Fax: 440-934-2602
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 126800000X |
| Taxonomy | Dental Assistant |
| License Number | 51.017922 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: