Provider Demographics
NPI:1427116623
Name:VOMBERGAR, MIRKO F (DDS)
Entity type:Individual
Prefix:DR
First Name:MIRKO
Middle Name:F
Last Name:VOMBERGAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2770 SOM CENTER RD
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44094-9116
Mailing Address - Country:US
Mailing Address - Phone:440-473-4746
Mailing Address - Fax:440-473-0082
Practice Address - Street 1:2770 SOM CENTER RD
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44094-9116
Practice Address - Country:US
Practice Address - Phone:440-473-4746
Practice Address - Fax:440-473-0082
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH199581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice