Provider Demographics
NPI:1396017315
Name:WARD, DENNIS MICHAEL (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:MICHAEL
Last Name:WARD
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 1:32745 WALKER ROAD
Mailing Address - Street 2:SUITE D
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012
Mailing Address - Country:US
Mailing Address - Phone:440-933-6525
Mailing Address - Fax:440-933-6713
Practice Address - Street 1:32745 WALKER RD
Practice Address - Street 2:SUITE D
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-2249
Practice Address - Country:US
Practice Address - Phone:440-933-6525
Practice Address - Fax:440-933-6713
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH168771223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics