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General NPI Number Information
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NPI Number | 1477617082
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Entity Type | Organization
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Legal Business Name | BRADLEY WARREN HYLAN, DDS, INC.
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 12/14/2009
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Provider Practice Location Address
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Address Line | 3447 W 117TH ST
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City | CLEVELAND
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State | OH
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Zip | 44111-3520
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Country | US
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Telephone | 216-251-8812
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Fax | 216-252-2448
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Provider Business Mailing Address
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Address Line | 3447 W 117TH ST
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City | CLEVELAND
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State | OH
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Zip | 44111-3520
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Country | US
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Telephone | 216-251-8812
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Fax | 216-252-2448
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SUSAN G HYLAN
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Credential |
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Telephone | 216-251-8812
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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 | 16257
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License Number State | OH
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