MEDICARE: DR. NEIL LYNN CANTOR D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	13047	OH

General Provider Information

NPI Number	:	1215068184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEIL LYNN CANTOR D.D.S.

Provider Business Mailing Address
First Line	:	5432 MAYFIELD RD
Second Line	:	202
City	:	LYNDHURST
State	:	OH
Zip	:	44124-2930
Country	:	US
Telephone Number	:	440-442-3800
Fax Number	:	440-442-9104

Provider Business Practice Location Address
First Line	:	5432 MAYFIELD RD
Second Line	:	202
City	:	LYNDHURST
State	:	OH
Zip	:	44124-2930
Country	:	US
Telephone Number	:	440-442-3800
Fax Number	:	440-442-9104

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	07/08/2007

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