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General NPI Number Information
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NPI Number | 1891727558
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Entity Type | Organization
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Legal Business Name | JOHN A HUDEC CLEVELAND DENTAL HEALTH CENTER INC
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 12409 LORAIN AVENUE
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City | CLEVELAND
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State | OH
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Zip | 44111-3515
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Country | US
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Telephone | 216-252-6622
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Fax | 216-252-4462
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Provider Business Mailing Address
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Address Line | 12409 LORAIN AVENUE
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City | CLEVELAND
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State | OH
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Zip | 44111-3515
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Country | US
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Telephone | 216-252-6622
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Fax | 216-252-4462
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN A HUDEC
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Credential | DDS
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Telephone | 216-398-8900
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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 |
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