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Organization

MODELO DENTAL CARE, INC.

Active
Other names
Modelo Dental Care, Inc.
Organization subpart
No

Provider details

NPI number
Authorized official
SARA NAZCO (DDS)
(216) 687-0062
Entity
Organization

Contact information

Practice address
2012 W 25TH ST, #720, CLEVELAND, OH 44113-4135
(216) 687-0062
(216) 687-9529
Mailing address
2012 W 25TH ST, CLEVELAND, OH 44113-4131
(216) 687-0062
(216) 687-9529

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3019317
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0918476
OH
Enumeration date
05/16/2006
Last updated
10/20/2008
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