Organization
JEROME S KUSTIN D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME S KUSTIN DDS (DENTIST/OWNER)
(216) 741-4600
Entity
Organization
Contact information
Practice address
5455 BROADVIEW RD., #100, PARMA, OH 44134
(216) 741-4600
(216) 749-0960
Mailing address
5455 BROADVIEW RD., #100, PARMA, OH 44134
(216) 741-4600
(216) 749-0960
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12902
OH
1223G0001X
General Practice Dentistry
12902
OH
Other
Enumeration date
11/14/2005
Last updated
11/29/2010
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