Provider Demographics
NPI:1568488906
Name:WILLIAM L EICK, D.D.S., INC.
Entity Type:Organization
Organization Name:WILLIAM L EICK, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:EICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:440-333-1915
Mailing Address - Street 1:21851 CENTER RIDGE RD
Mailing Address - Street 2:SUITE #415
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3976
Mailing Address - Country:US
Mailing Address - Phone:440-333-1915
Mailing Address - Fax:440-333-1614
Practice Address - Street 1:21851 CENTER RIDGE RD
Practice Address - Street 2:SUITE #415
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3976
Practice Address - Country:US
Practice Address - Phone:440-333-1915
Practice Address - Fax:440-333-1614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH15971261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental