Individual
MOHAMED OTHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2124 CORNELL RD, CLEVELAND, OH 44106-3804
(734) 277-2897
Mailing address
12900 LAKE AVE, APT 2007, LAKEWOOD, OH 44107-1577
(734) 277-2897
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401414004
VA
122300000X
Dentist
Primary
30.024057
OH
Other
Enumeration date
06/06/2013
Last updated
08/01/2013
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