Provider Demographics
NPI:1811394109
Name:BOERIU, IOAN SORIN (DDA,MSD)
Entity Type:Individual
Prefix:MR
First Name:IOAN
Middle Name:SORIN
Last Name:BOERIU
Suffix:
Gender:M
Credentials:DDA,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4447 TALMADGE RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623
Mailing Address - Country:US
Mailing Address - Phone:216-368-3615
Mailing Address - Fax:419-473-1452
Practice Address - Street 1:4447 TALMADGE RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623
Practice Address - Country:US
Practice Address - Phone:216-368-3615
Practice Address - Fax:419-473-1452
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-02
Last Update Date:2019-09-19
Deactivation Date:2015-10-16
Deactivation Code:
Reactivation Date:2019-09-19
Provider Licenses
StateLicense IDTaxonomies
OH34171223P0300X
OH30.0256171223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics