Organization
WESTERN RESERVE CENTER FOR OROFACIAL AND COSMETIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS C DIAMANTIS MD (OWNER)
(216) 227-3333
Entity
Organization
Contact information
Practice address
14700 DETROIT AVE, LAKEWOOD, OH 44107-4116
(216) 227-3333
(216) 226-3700
Mailing address
14700 DETROIT AVE, LAKEWOOD, OH 44107-4116
(216) 227-3333
(216) 226-3700
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
10/13/2009
Last updated
10/13/2009
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