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Organization
NORTH COAST JAW CENTER. LLC
Active
Organization
NORTH COAST JAW CENTER. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN R BLAKEMORE DDS (PRESIDENT)
(440) 734-3131
Entity
Organization
Contact information
Practice address
26777 LORAIN RD, SUITE 600, NORTH OLMSTED, OH 44070-3200
(440) 734-3131
(440) 734-3466
Mailing address
26777 LORAIN RD, SUITE 600, NORTH OLMSTED, OH 44070-3200
(440) 734-3131
(440) 734-3466
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
12/13/2006
Last updated
10/26/2012
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