Organization
ROSEWATER DENTAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD A KORMOS D.D.S. (PRESIDENT)
(216) 861-2124
Entity
Organization
Contact information
Practice address
2626 LORAIN AVE, CLEVELAND, OH 44113-3415
(216) 861-2124
(216) 861-4025
Mailing address
2626 LORAIN AVE, CLEVELAND, OH 44113-3415
(216) 861-2124
(216) 861-4025
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30-18772
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312263
—
OH
Enumeration date
03/16/2007
Last updated
12/31/2018
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