Individual
BLAINE EDWARD GRIFFITHS IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9601 CHESTER AVE, CLEVELAND, OH 44106-1666
(216) 368-8730
Mailing address
3000 SOUTHWIND TRL, YOUNGSTOWN, OH 44514-2880
(513) 240-1919
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30-027295
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/21/2022
Last updated
10/24/2023
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