Organization
DR KMIECKS DENTAL HEALTH SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH T KMIECK DDS (OWNER PRESIDENT)
(440) 888-9755
Entity
Organization
Contact information
Practice address
7057 W 130 STREET, PARMA HEIGHTS, OH 44130
(440) 888-9755
(440) 888-8763
Mailing address
7057 W 130 STREET, PARMA HEIGHTS, OH 44130
(440) 888-9755
(440) 888-8763
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0281770
—
OH
Enumeration date
09/01/2006
Last updated
08/22/2020
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