Organization
AMHERST ORAL SURGERY AND IMPLANT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY W KOSMAN D.D.S. (OWNER)
(440) 988-3400
Entity
Organization
Contact information
Practice address
550 N LEAVITT RD, AMHERST, OH 44001-1131
(440) 988-3400
(440) 988-3405
Mailing address
550 N LEAVITT RD, AMHERST, OH 44001-1131
(440) 988-3400
(440) 988-3405
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
35099912
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0065520
—
OH
Enumeration date
09/25/2012
Last updated
09/25/2012
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