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General NPI Number Information
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NPI Number | 1992811921
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Entity Type | Organization
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Legal Business Name | JOSEPH A. KOBERLEIN DDS, MS, INC.
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3869 DARROW RD SUITE 201
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City | STOW
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State | OH
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Zip | 44224-2691
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Country | US
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Telephone | 330-688-9922
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Fax | 330-688-1314
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Provider Business Mailing Address
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Address Line | 3869 DARROW RD SUITE 201
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City | STOW
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State | OH
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Zip | 44224-2691
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Country | US
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Telephone | 330-688-9922
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Fax | 330-688-1314
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH A. KOBERLEIN
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Credential | DDS
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Telephone | 330-688-9922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 18241
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License Number State | OH
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