Provider Demographics
NPI:1780756734
Name:MARK KRIWINSKY DDS INC
Entity type:Organization
Organization Name:MARK KRIWINSKY DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:KRIWINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:216-382-2121
Mailing Address - Street 1:14443 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3309
Mailing Address - Country:US
Mailing Address - Phone:216-382-2121
Mailing Address - Fax:216-382-7083
Practice Address - Street 1:14443 CEDAR RD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-3309
Practice Address - Country:US
Practice Address - Phone:216-382-2121
Practice Address - Fax:216-382-7083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH164401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty