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General NPI Number Information
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NPI Number | 1073902920
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Entity Type | Organization
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Legal Business Name | DAVID M. SORBORO, D.D.S. M.S. LLC
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 26777 LORAIN RD SUITE #706
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City | NORTH OLMSTED
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State | OH
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Zip | 44070-3200
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Country | US
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Telephone | 440-979-0055
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Fax | 440-979-0056
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Provider Business Mailing Address
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Address Line | 26777 LORAIN RD SUITE #706
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City | NORTH OLMSTED
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State | OH
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Zip | 44070-3200
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Country | US
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Telephone | 440-979-0055
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Fax | 440-979-0056
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Authorized Official
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Title or Position | OWNER
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Name | DAVID M. SORBORO, D.D.S., M.S., LLC
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Credential | D.D.S., M.S., LLC
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Telephone | 440-979-0055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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