Provider Demographics
NPI:1750495834
Name:KAUFMAN, NEAL MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:MICHAEL
Last Name:KAUFMAN
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 1:30400 DETROIT ROAD
Mailing Address - Street 2:SUITE #303
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145
Mailing Address - Country:US
Mailing Address - Phone:440-871-1173
Mailing Address - Fax:440-871-1196
Practice Address - Street 1:30400 DETROIT ROAD
Practice Address - Street 2:SUITE #303
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145
Practice Address - Country:US
Practice Address - Phone:440-871-1173
Practice Address - Fax:440-871-1196
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300183281223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics