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Individual

DR. DIANNE MARIE MCDONALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
17500 MADISON AVE, LAKEWOOD, OH 44107-3535
(216) 521-2424
(216) 521-8497
Mailing address
17500 MADISON AVE, LAKEWOOD, OH 44107-3535
(216) 521-2424
(216) 521-8497

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30.015479
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30.015479
DENTAL LICENSE
OH
01
7928
DENTAL LICENSE
FL
Enumeration date
11/14/2006
Last updated
07/08/2007
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