Individual
DR. ELLIOTT DANIEL DETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
7528 PEARL RD, MIDDLEBURG HEIGHTS, OH 44130-6430
(440) 888-6783
Mailing address
2317 GRANDVIEW AVE, CLEVELAND HEIGHTS, OH 44106-3119
(419) 989-7715
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30.027603
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2024
Last updated
06/05/2024
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