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Organization
LEHKY STATE DENTAL PROVIDERS, LLC
Active
Organization
LEHKY STATE DENTAL PROVIDERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY R CREEK CDA (DIRECTOR)
(330) 224-9528
Entity
Organization
Contact information
Practice address
2820 W MARKET ST STE 100, FAIRLAWN, OH 44333-4061
(330) 864-3331
Mailing address
2820 W MARKET ST STE 100, FAIRLAWN, OH 44333-4061
(330) 864-3331
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
NULL
1223D0001X
Public Health Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
NULL
Other
Enumeration date
10/05/2022
Last updated
10/05/2022
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