Organization
COSMETIC & FAMILY DENTAL STUDIOS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ABRAHAM H BOADI DMD (PRESIDENT & CEO)
(419) 534-2479
Entity
Organization
Contact information
Practice address
36 S BYRNE RD, TOLEDO, OH 43615-6211
(419) 534-2479
(419) 534-3260
Mailing address
36 S BYRNE RD, TOLEDO, OH 43615-6211
(419) 534-2479
(419) 534-3260
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18842
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01541
PARAMOUNT ADVANTAGE
OH
05
—
0719486
—
OH
01
—
18842-436156211
DELTA DENTAL OH/MI
OH
Enumeration date
02/06/2006
Last updated
08/22/2020
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