Individual
DR. ANDRE KEVIN MICKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MSD
Contact information
Practice address
3609 PARK EAST, SUITE 407, BEACHWOOD, OH 44122
(216) 831-3636
(216) 831-3639
Mailing address
3609 PARK EAST, SUITE 407, BEACHWOOD, OH 44122
(216) 831-3636
(216) 831-3639
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
30019947
OH
Other
Enumeration date
12/08/2006
Last updated
07/08/2007
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