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NPI Code Detail

MEDICARE: DENTAL PROFESSIONALS CLEVELAND-NOUNEH, INC

MEDICARE: DENTAL PROFESSIONALS CLEVELAND-NOUNEH, INC
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
11223G0001XGeneral Practice Dentistry19758OH

General Provider Information

NPI Number : 1245398452
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTAL PROFESSIONALS CLEVELAND-NOUNEH, INC
Provider Business Mailing Address
First Line : 6315 PEARL RD
Second Line :
City : PARMA HEIGHTS
State : OH
Zip : 44130-3082
Country : US
Telephone Number : 440-345-9068
Fax Number : 440-842-6612
Provider Business Practice Location Address
First Line : 6315 PEARL RD
Second Line :
City : PARMA HEIGHTS
State : OH
Zip : 44130-3082
Country : US
Telephone Number : 440-345-9068
Fax Number : 440-842-6612
Authorized Official
Title or Position : OWNER
Name : IMAD NOUNEH
Credential : DDS
Telephone Number : 440-345-9068
Provider Enumeration Date : 12/04/2006
Last Update Date : 03/16/2009

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Directions to “DENTAL PROFESSIONALS CLEVELAND-NOUNEH, INC ” Practice Location

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