Organization
LEIDENHEIMER DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER ANN SOCHACKI (MANAGER)
(440) 324-3441
Entity
Organization
Contact information
Practice address
42707 N RIDGE RD, ELYRIA, OH 44035-1054
(440) 324-3441
Mailing address
42707 N RIDGE RD, ELYRIA, OH 44035-1054
(440) 324-3441
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015325
—
OH
05
—
2093907
—
OH
05
—
2203538
—
OH
05
—
2825410
—
OH
Enumeration date
10/19/2011
Last updated
01/26/2012
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