Organization
LEIDENHEIMER DENTAL GROUP, INC.
Active
Other names
James L. Matz DDS, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER A SOCHACKI (OFFICE MANAGER/TREASURER)
(440) 444-0379
Entity
Organization
Contact information
Practice address
42707 N RIDGE RD, ELYRIA, OH 44035-1054
(440) 444-0379
(440) 654-2778
Mailing address
42707 N RIDGE RD, ELYRIA, OH 44035-1054
(440) 444-0379
(440) 654-2778
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30020876
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015325
—
OH
05
—
2093907
—
OH
05
—
2203538
—
OH
05
—
2825410
—
OH
05
—
3107033
—
OH
05
—
4614975
—
OH
Enumeration date
03/10/2008
Last updated
06/02/2015
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