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General NPI Number Information
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NPI Number | 1972613180
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Entity Type | Individual
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Provider Name | ALICE M DENTON M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 12/03/2020
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Provider Practice Location Address
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Address Line | 4001 CARRICK DR STE 210
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City | MEDINA
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State | OH
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Zip | 44256-5393
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Country | US
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Telephone | 330-725-3009
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Fax | 330-722-7502
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Provider Business Mailing Address
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Address Line | 24701 EUCLID AVE THIRD FLOOR BILLING SERVICES
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City | EUCLID
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State | OH
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Zip | 44117-1714
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Country | US
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Telephone | 330-725-3009
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Fax | 330-722-7502
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35069291
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License Number State | OH
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