Individual
COLLEEN VIENNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
26777 LORAIN RD, SUITE 500, NORTH OLMSTED, OH 44070
(440) 734-7300
(440) 734-7376
Mailing address
26777 LORAIN RD, SUITE 500, NORTH OLMSTED, OH 44070
(440) 734-7300
(440) 734-7376
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19284
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19284
STATE LICENSE NUMBER
OH
Enumeration date
10/17/2006
Last updated
07/08/2007
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