Provider Demographics
NPI:1477617082
Name:BRADLEY WARREN HYLAN, DDS, INC.
Entity Type:Organization
Organization Name:BRADLEY WARREN HYLAN, DDS, INC.
Other - Org Name:HYLAN DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:HYLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-251-8812
Mailing Address - Street 1:3447 W 117TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-3520
Mailing Address - Country:US
Mailing Address - Phone:216-251-8812
Mailing Address - Fax:216-252-2448
Practice Address - Street 1:3447 W 117TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-3520
Practice Address - Country:US
Practice Address - Phone:216-251-8812
Practice Address - Fax:216-252-2448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH162571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty