MEDICARE: YORK DENTAL LLC

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	21738	OH

General Provider Information

NPI Number	:	1376832063
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YORK DENTAL LLC

Provider Business Mailing Address
First Line	:	6390 YORK RD
Second Line	:
City	:	PARMA HEIGHTS
State	:	OH
Zip	:	44130-3028
Country	:	US
Telephone Number	:	440-884-2424
Fax Number	:	440-884-3828

Provider Business Practice Location Address
First Line	:	6390 YORK RD
Second Line	:
City	:	PARMA HEIGHTS
State	:	OH
Zip	:	44130-3028
Country	:	US
Telephone Number	:	440-884-2424
Fax Number	:	440-884-3828

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	MAJDI I ALRABADY
Credential	:	DDS, BDS, FAGD
Telephone Number	:	440-884-2424

Provider Enumeration Date	:	04/03/2011
Last Update Date	:	04/03/2011

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