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General NPI Number Information
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NPI Number | 1245907781
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Entity Type | Individual
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Provider Name | BARRY DIAMOND DDS
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Gender | Male
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Dates
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Enumeration Date | 08/24/2021
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Last Update Date | 10/29/2021
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Provider Practice Location Address
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Address Line | 3690 ORANGE PL STE 460
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City | BEACHWOOD
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State | OH
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Zip | 44122-4438
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Country | US
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Telephone | 216-371-4777
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Fax |
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Provider Business Mailing Address
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Address Line | 4457 GROVELAND RD
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City | UNIVERSITY HEIGHTS
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State | OH
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Zip | 44118-3920
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Country | US
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Telephone | 216-288-5357
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30.026629
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License Number State | OH
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