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Organization

CWRU FACULTY DENTAL PRACTICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHRYN DAVOL CHAPMAN M.ED (ADMINISTRATOR)
(216) 368-0592
Entity
Organization

Contact information

Practice address
2123 ABINGTON ROAD, CLEVELAND, OH 44106-4905
(216) 368-0592
(216) 368-6310
Mailing address
10900 EUCLID AVENUE, SCHOOL OF DENTAL MEDICINE/FACULTY PRACTICE, CLEVELAND, OH 44106-4905
(216) 368-0592
(216) 368-6310

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
30-00150
OH
1223G0001X
General Practice Dentistry
30-18847
OH
1223G0001X
General Practice Dentistry
30-20215
OH
1223P0300X
Periodontics
30-022076
OH
1223P0700X
Prosthodontics
30-00194
OH
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
30-00149
OH
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
30-021785
OH

Other

Enumeration date
12/12/2006
Last updated
09/11/2025
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