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| Type | Company | [sources] | |||
|---|---|---|---|---|---|
| Name | Buckeye Family Dental | [sources] | |||
| Incorporation date | not available | [sources] | |||
| Jurisdiction | not available | [sources] | |||
| Country | United States of America | [sources] | |||
| Description | Provider ID: 0095896 | [sources] | |||
| NPI | 1649691106 | [sources] | |||
| Registration number | not available | [sources] | |||
| Sector | 31 - Professional Dental Group | [sources] | |||
| Address | 4163 Pearl Road, Cleveland, OH 44109 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers excluded or suspended from Ohio's Medicaid program.
United States of America · ODM
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States of America | Ohio Department of Medicaid | - | |||
| Address | ||
|---|---|---|
| Full address | Country | |
| 4163 Pearl Road, Cleveland, OH 44109 | United States of America | |