Greenbaum, Marc R

Greenbaum, Marc R is an individual health care provider with primary practice located at 18611 Detroit Ave , Lakewood OH 44107. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Greenbaum, Marc R can be contacted via phone (216) 221-2210.

Contact Information

Primary practice address
18611 Detroit Ave Lakewood OH 44107
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 15147 Ohio

Profile Details

NPI number 1427094564
LBN Legal business name Greenbaum, Marc R
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427094564 NPPES
Ohio MEDICAID 0455449

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