Individual
LEA VAN KLINE-SHIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
5700 YOUNGSTOWN WARREN RD STE 107, NILES, OH 44446-4707
(330) 652-3900
Mailing address
4225 RUSH BLVD, YOUNGSTOWN, OH 44512-1262
(330) 261-2434
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
RES.004113
OH
1223G0001X
General Practice Dentistry
Primary
30.026183
OH
Other
Enumeration date
05/23/2019
Last updated
05/03/2026
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