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General NPI Number Information
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NPI Number | 1366954430
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Entity Type | Organization
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Legal Business Name | DRS. AGRONIN & SWEENEY - ORTHODONTICS, LLC
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Dates
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Enumeration Date | 10/30/2017
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Last Update Date | 10/30/2017
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Provider Practice Location Address
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Address Line | 25165 COUNTRY CLUB BLVD
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City | NORTH OLMSTED
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State | OH
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Zip | 44070-5312
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Country | US
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Telephone | 440-979-9500
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Fax | 440-979-9407
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Provider Business Mailing Address
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Address Line | 25165 COUNTRY CLUB BLVD
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City | NORTH OLMSTED
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State | OH
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Zip | 44070-5312
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Country | US
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Telephone | 440-979-9500
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Fax | 440-979-9407
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Authorized Official
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Title or Position | PARTNER
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Name | DR. WILLIAM JOHN SWEENEY JR.
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Credential | D.D.S., M.S.
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Telephone | 440-979-9500
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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 | 21170
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License Number State | OH
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