Organization
BEACHCLIFF DENTAL ASSOCIATES OF ROCKY RIVER - A THEODOROU DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA CHASE (INSURANCE SPECIALIST)
(440) 356-2089
Entity
Organization
Contact information
Practice address
19111 DETROIT RD STE 204, ROCKY RIVER, OH 44116-1740
(440) 356-1000
(440) 356-2090
Mailing address
19111 DETROIT RD STE 206, ROCKY RIVER, OH 44116-1740
(440) 356-1000
(440) 356-2090
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0402338
—
OH
Enumeration date
08/28/2020
Last updated
08/28/2020
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