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General NPI Number Information
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NPI Number | 1649691106
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Entity Type | Organization
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Legal Business Name | BUCKEYE FAMILY DENTAL PRESENTED BY DR YAZAN ALMADANI LLC
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Dates
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Enumeration Date | 12/30/2013
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Last Update Date | 12/30/2013
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Provider Practice Location Address
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Address Line | 4163 PEARL RD
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City | CLEVELAND
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State | OH
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Zip | 44109-3332
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Country | US
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Telephone | 216-862-4990
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Fax | 216-862-3585
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Provider Business Mailing Address
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Address Line | 4163 PEARL RD
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City | CLEVELAND
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State | OH
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Zip | 44109-3332
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Country | US
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Telephone | 216-862-4990
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Fax | 216-862-3585
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | DR. YAZAN B AL-MADANI
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Credential | DDS
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Telephone | 440-454-4878
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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 |
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License Number State | OH
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