Organization
KHAVIS LLC
Active
Other names
Dream Dental
Organization subpart
No
Provider details
NPI number
Authorized official
RAFAEL KHAVIS DDS (STATUTORY AGENT/DENTIST)
(917) 822-4185
Entity
Organization
Contact information
Practice address
5596 MAYFIELD RD, LYNDHURST, OH 44124-2921
(440) 442-8220
Mailing address
4499 GROVELAND RD, UNIVERSITY HEIGHTS, OH 44118-3920
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/24/2022
Last updated
11/24/2022
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