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NPI Code Detail

MEDICARE: DAVID L FORTHOFER DDS INC

MEDICARE: DAVID L FORTHOFER DDS 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 Dentistry30014832OH

General Provider Information

NPI Number : 1750436507
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVID L FORTHOFER DDS INC
Provider Business Mailing Address
First Line : 35590 CENTER RIDGE ROAD
Second Line : SUITE 102
City : NORTH RIDGEVILLE
State : OH
Zip : 44039-3057
Country : US
Telephone Number : 440-327-0700
Fax Number : 440-327-0237
Provider Business Practice Location Address
First Line : 35590 CENTER RIDGE RD
Second Line : SUITE 102
City : NORTH RIDGEVILLE
State : OH
Zip : 44039-3057
Country : US
Telephone Number : 440-327-0700
Fax Number : 440-327-0237
Authorized Official
Title or Position : DENTIST PRESIDENT
Name : DR. DAVID LEE FORTHOFER
Credential : DDS
Telephone Number : 440-327-0700
Provider Enumeration Date : 01/24/2007
Last Update Date : 09/17/2007

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Directions to “DAVID L FORTHOFER DDS INC ” Practice Location

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