Individual
DR. RON MICCHIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9140 LAKESHORE BLVD, MENTOR, OH 44060
(440) 257-3900
Mailing address
9140 LAKE SHORE BLVD, MENTOR, OH 44060-1637
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
15919
OH
Other
Enumeration date
01/07/2014
Last updated
01/07/2014
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