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Organization
WESTERN RESERVE PERIODONTICS, INC
Active
Organization
WESTERN RESERVE PERIODONTICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDRICK A ROSENBERG D.D.S. (SECRETARY/TREASURER)
(216) 464-8985
Entity
Organization
Contact information
Practice address
3609 PARK EAST DR, #411, BEACHWOOD, OH 44122-4331
(216) 464-7338
Mailing address
3609 PARK EAST DR, #411, BEACHWOOD, OH 44122-4331
(216) 464-7338
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
10/15/2007
Last updated
10/15/2007
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