# DENTAL GROUP OF MENTOR

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

## Provider details

- **NPI number:** 1699047670
- **Authorized official:** DR. JONATHAN JAY KLINEMAN (OWNER)
- **Authorized official phone:** (440) 352-5700

## Contact information

- **Practice address:** 9571 MENTOR AVE, MENTOR, OH 44060-4521
- **Practice address phone:** (440) 352-5700
- **Practice address fax:** (440) 352-5721
- **Mailing address:** 9571 MENTOR AVE, MENTOR, OH 44060-4521
- **Mailing address phone:** (440) 352-5700
- **Mailing address fax:** (440) 352-5721

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 30021252 | OH | Yes |

## Other

- **Enumeration date:** 02/06/2012
- **Last updated:** 02/06/2012