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General NPI Number Information
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NPI Number | 1972750198
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Entity Type | Organization
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Legal Business Name | HAMILTON-CLEVES DENTAL CENTER
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Dates
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Enumeration Date | 08/19/2008
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 3757 HAMILTON CLEVES RD
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City | HAMILTON
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State | OH
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Zip | 45013-9557
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Country | US
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Telephone | 513-738-4900
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Fax | 513-738-1464
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Provider Business Mailing Address
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Address Line | 3757 HAMILTON CLEVES RD
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City | HAMILTON
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State | OH
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Zip | 45013-9557
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Country | US
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Telephone | 513-738-4900
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Fax | 513-738-1464
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Authorized Official
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Title or Position | DENTIST
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Name | DR. CLAUDIA LIZZETTE GONZALEZ
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Credential | D.M.D.
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Telephone | 513-738-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 30-022224
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License Number State | OH
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