NPI 1093100430 · live from the CMS NPI Registry
Lea Bouserhal
Dentist, Orthodontics and Dentofacial Orthopedics in Cleveland, OH. National Provider Identifier 1093100430, active.
NPI record
| NPI | 1093100430 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 10900 Euclid Ave, Cleveland, OH 44106 |
| Practice phone | 216-368-3200 |
| Enumerated | April 2, 2015 |
| Last updated | April 2, 2015 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | RES.3507 (OH) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.