Provider Demographics
NPI:1467279307
Name:APOLLO GENERAL DENTISTRY LLC
Entity type:Organization
Organization Name:APOLLO GENERAL DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:ALEXANDRA
Authorized Official - Last Name:TALPOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-582-2122
Mailing Address - Street 1:5253 WALLINGS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-3135
Mailing Address - Country:US
Mailing Address - Phone:440-582-2122
Mailing Address - Fax:440-628-9013
Practice Address - Street 1:5253 WALLINGS RD
Practice Address - Street 2:
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-3135
Practice Address - Country:US
Practice Address - Phone:440-582-2122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental