Organization
ELITE DENTISTRY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOGDAN S BUTRIY DDS (OWNER)
(216) 464-3200
Entity
Organization
Contact information
Practice address
24300 CHAGRIN BLVD, SUITE 304, BEACHWOOD, OH 44122-5639
(216) 464-3200
(216) 464-3201
Mailing address
24300 CHAGRIN BLVD, SUITE 304, BEACHWOOD, OH 44122-5639
(216) 464-3200
(216) 464-3201
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
30.022982
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
293757
—
OH
Enumeration date
08/26/2014
Last updated
08/26/2014
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