Organization
NORTHEAST OHIO CENTER FOR DENTAL SLEEP MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS E DESATNIK DDS (PRESIDENT)
(216) 831-1170
Entity
Organization
Contact information
Practice address
22901 MILLCREEK BLVD, SUITE #140, BEACHWOOD, OH 44122-5728
(216) 831-1170
Mailing address
22901 MILLCREEK BLVD, SUITE #140, BEACHWOOD, OH 44122-5728
(216) 831-1170
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
OH 30-023233
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417269820
UPIN
OH
Enumeration date
02/25/2017
Last updated
11/28/2017
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