Provider Demographics
NPI:1013198878
Name:DEFINA, MIGUEL LEWIS (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:LEWIS
Last Name:DEFINA
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29001 CEDAR RD
Mailing Address - Street 2:SUITE 450
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4062
Mailing Address - Country:US
Mailing Address - Phone:440-461-3400
Mailing Address - Fax:440-461-1722
Practice Address - Street 1:29001 CEDAR RD
Practice Address - Street 2:SUITE 450
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-4062
Practice Address - Country:US
Practice Address - Phone:440-461-3400
Practice Address - Fax:440-461-1722
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300220881223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics