Provider Demographics
NPI:1972750198
Name:HAMILTON-CLEVES DENTAL CENTER
Entity Type:Organization
Organization Name:HAMILTON-CLEVES DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:LIZZETTE
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:513-738-4900
Mailing Address - Street 1:3757 HAMILTON CLEVES RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-9557
Mailing Address - Country:US
Mailing Address - Phone:513-738-4900
Mailing Address - Fax:513-738-1464
Practice Address - Street 1:3757 HAMILTON CLEVES RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-9557
Practice Address - Country:US
Practice Address - Phone:513-738-4900
Practice Address - Fax:513-738-1464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-022224261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center