Provider Demographics
NPI:1720180789
Name:OGRINC, ANTON JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTON
Middle Name:JOHN
Last Name:OGRINC
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6551 WILSON MILLS RD
Mailing Address - Street 2:SUITE #103
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3495
Mailing Address - Country:US
Mailing Address - Phone:440-473-1920
Mailing Address - Fax:440-473-0082
Practice Address - Street 1:6551 WILSON MILLS RD
Practice Address - Street 2:SUITE #103
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44143-3495
Practice Address - Country:US
Practice Address - Phone:440-473-1920
Practice Address - Fax:440-473-0082
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH164661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice