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General NPI Number Information
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NPI Number | 1407919129
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Entity Type | Individual
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Provider Name | FRANK F OMERZA D.D.S., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 08/24/2011
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Provider Practice Location Address
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Address Line | 4122 WHIPPLE AVE NORTHWEST
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City | CANTON
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State | OH
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Zip | 44718
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Country | US
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Telephone | 330-492-7920
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Fax |
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Provider Business Mailing Address
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Address Line | 38305 DODDS HILL DR
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City | WILLOUGHBY HILLS
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State | OH
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Zip | 44094-6967
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Country | US
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Telephone | 440-946-6934
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 30018817
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License Number State | OH
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