Provider Demographics
NPI:1235324757
Name:HARRY S RZEPKA DDS INC
Entity Type:Organization
Organization Name:HARRY S RZEPKA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:S
Authorized Official - Last Name:RZEPKA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:216-382-7665
Mailing Address - Street 1:5035 MAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124
Mailing Address - Country:US
Mailing Address - Phone:216-382-7665
Mailing Address - Fax:216-382-1001
Practice Address - Street 1:5035 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124
Practice Address - Country:US
Practice Address - Phone:216-382-7665
Practice Address - Fax:216-382-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30011682122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty