Organization
CROSS CREEK FAMILY DENTAL
Active
Other names
Cross Creek Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IGOR J. SKALSKY DDS (CEO/OWNER)
(330) 273-1544
Entity
Organization
Contact information
Practice address
3915 CENTER RD, BRUNSWICK, OH 44212-3087
(330) 237-1544
Mailing address
3915 CENTER RD, BRUNSWICK, OH 44212-3087
(330) 237-1544
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30.016564
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30.016564
OHIO LICENSE 30.016564
OH
Enumeration date
04/18/2016
Last updated
04/18/2016
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