MEDICARE: DR. ANTON JOHN OGRINC DDS

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	16466	OH

General Provider Information

NPI Number	:	1720180789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTON JOHN OGRINC DDS

Provider Business Mailing Address
First Line	:	6551 WILSON MILLS RD
Second Line	:	SUITE #103
City	:	CLEVELAND
State	:	OH
Zip	:	44143-3495
Country	:	US
Telephone Number	:	440-473-1920
Fax Number	:	440-473-0082

Provider Business Practice Location Address
First Line	:	6551 WILSON MILLS RD
Second Line	:	SUITE #103
City	:	CLEVELAND
State	:	OH
Zip	:	44143-3495
Country	:	US
Telephone Number	:	440-473-1920
Fax Number	:	440-473-0082

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

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	07/08/2007

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