Individual
DR. MOHAMMED ALI KANAWATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS,MBA,MS
Contact information
Practice address
31099 CHAGRIN BLVD, SUITE 100, PEPPER PIKE, OH 44124-5958
(216) 450-5888
(216) 450-5505
Mailing address
3671 COLUMBIA RD, NORTH OLMSTED, OH 44070-2038
(216) 450-5888
(216) 450-5505
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30-022374
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30-022374
OHIO STATE DENTAL LICENSE
OH
Enumeration date
05/17/2007
Last updated
10/05/2020
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