National Provider Identifier Database

WESTERN RESERVE CENTER FOR OROFACIAL AND COSMETIC SURGERY
Oral and Maxillofacial Surgery

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.


Contact Information

WESTERN RESERVE CENTER FOR OROFACIAL AND COSMETIC SURGERY
14700 DETROIT AVE
LAKEWOOD, OH44107-4116
Phone: 216-227-3333
Fax: 216-226-3700
Website:
Specialty Taxonomy Code
* Oral and Maxillofacial Surgery 261QS0112X

* Indicates primary specialty

NPI Profile & details for WESTERN RESERVE CENTER FOR OROFACIAL AND COSMETIC SURGERY

NPI Number 1427383272
Legal business name
LBN
WESTERN RESERVE CENTER FOR OROFACIAL AND COSMETIC SURGERY
Authorized official NICHOLAS DIAMANTIS - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 10/13/2009
Last updated 10/13/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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