Provider Demographics
NPI:1821178773
Name:DRS. DROBOTIJ, GORMAN, COLACO, JURCAK, AND FLYNN, INC.
Entity Type:Organization
Organization Name:DRS. DROBOTIJ, GORMAN, COLACO, JURCAK, AND FLYNN, INC.
Other - Org Name:NORTHCOAST ENDODONTIC SPECIALISTS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:C
Authorized Official - Last Name:GORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:440-446-1300
Mailing Address - Street 1:29001 CEDAR ROAD
Mailing Address - Street 2:SUITE #453
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4062
Mailing Address - Country:US
Mailing Address - Phone:440-446-1300
Mailing Address - Fax:440-446-0907
Practice Address - Street 1:29001 CEDAR RD
Practice Address - Street 2:SUITE #453
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-4062
Practice Address - Country:US
Practice Address - Phone:440-446-1300
Practice Address - Fax:440-446-0907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty