# NORTH COAST JAW CENTER. LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255492054
- **Authorized official:** DR. JOHN R BLAKEMORE DDS (PRESIDENT)
- **Authorized official phone:** (440) 734-3131

## Contact information

- **Practice address:** 26777 LORAIN RD, SUITE 600, NORTH OLMSTED, OH 44070-3200
- **Practice address phone:** (440) 734-3131
- **Practice address fax:** (440) 734-3466
- **Mailing address:** 26777 LORAIN RD, SUITE 600, NORTH OLMSTED, OH 44070-3200
- **Mailing address phone:** (440) 734-3131
- **Mailing address fax:** (440) 734-3466

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 12/13/2006
- **Last updated:** 10/26/2012