Provider Demographics
NPI:1295908564
Name:BRECKSVILLE DENTAL EXCELLENCE
Entity type:Organization
Organization Name:BRECKSVILLE DENTAL EXCELLENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:USMET
Authorized Official - Last Name:SALEH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:440-546-9494
Mailing Address - Street 1:8423 CHIPPEWA RD
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-2014
Mailing Address - Country:US
Mailing Address - Phone:440-546-9494
Mailing Address - Fax:
Practice Address - Street 1:8423 CHIPPEWA RD
Practice Address - Street 2:
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-2014
Practice Address - Country:US
Practice Address - Phone:440-546-9494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.021418122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty