Organization
DR. KMIECK'S DENTAL HEALTH SERVICE INC
Active
Parent organization
DR. KMIECK'S DENTAL HEALTH SERVICE INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DR. KMIECK'S DENTAL HEALTH SERVICE INC
Authorized official
DR. KENNETH THOMAS KMIECK DDS (PRESIDENT)
(440) 888-9755
Entity
Organization
Contact information
Practice address
7057 W 130TH ST, PARMA HEIGHTS, OH 44130-7841
(440) 888-9755
(440) 888-8763
Mailing address
7057 W 130TH ST, PARMA HEIGHTS, OH 44130-7841
(440) 888-9755
(440) 888-8763
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS030029L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0467990
—
OH
Enumeration date
07/16/2010
Last updated
07/16/2010
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