Individual
LEA BOUSERHAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10900 EUCLID AVE, CLEVELAND, OH 44106
(216) 368-3200
Mailing address
10900 EUCLID AVE, CLEVELAND, OH 44106
(216) 368-3200
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
RES.3507
OH
Other
Enumeration date
04/02/2015
Last updated
04/02/2015
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