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General NPI Number Information
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NPI Number | 1356098719
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Entity Type | Organization
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Legal Business Name | CARPE DIEM DENTAL SPA LLC
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Dates
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Enumeration Date | 03/06/2022
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 34570 AURORA RD STE A
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City | SOLON
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State | OH
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Zip | 44139
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Country | US
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Telephone | 440-589-4930
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Fax | 440-589-4931
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Provider Business Mailing Address
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Address Line | 34570 AURORA RD STE A
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City | SOLON
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State | OH
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Zip | 44139
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Country | US
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Telephone | 440-589-4930
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Fax | 440-589-4931
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Authorized Official
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Title or Position | OWNER
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Name | BOGDAN S BUTRIY
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Credential | DDS
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Telephone | 440-376-7705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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