Provider First Line Business Practice Location Address:
2124 CORNELL RD
Provider Second Line Business Practice Location Address:
DENTAL SCHOOL - ORTHODONTICS
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44106-3804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-368-2449
Provider Business Practice Location Address Fax Number:
216-368-3204
Provider Enumeration Date:
05/20/2014