Organization
30TH & O
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACLYN TOMSIC MD (PRESIDENT)
(440) 213-9459
Entity
Organization
Contact information
Practice address
3600 PARK EAST DR APT 539, BEACHWOOD, OH 44122-4358
(440) 213-9459
Mailing address
3600 PARK EAST DR APT 539, BEACHWOOD, OH 44122-4358
(440) 213-9459
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
04/26/2024
Last updated
05/01/2024
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