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General NPI Number Information
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NPI Number | 1356713242
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Entity Type | Organization
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Legal Business Name | DR ANDREW SLODOV DDS MSD
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Dates
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Enumeration Date | 10/30/2015
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Last Update Date | 10/30/2015
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Provider Practice Location Address
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Address Line | 8848 COMMONS BLVD SUITE 201
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City | TWINSBURG
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State | OH
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Zip | 44087
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Country | US
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Telephone | 216-346-5986
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Fax |
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Provider Business Mailing Address
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Address Line | 8848 COMMONS BLVD SUITE 201
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City | TWINSBURG
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State | OH
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Zip | 44087
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Country | US
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Telephone | 216-346-5986
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISS BRANDEY LOCKHART
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Credential |
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Telephone | 330-963-5905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 30018655
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License Number State | OH
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