Provider Demographics
NPI:1891590873
Name:T LATIF LLC
Entity type:Organization
Organization Name:T LATIF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:LATIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-800-0089
Mailing Address - Street 1:4466 DARROW RD STE 23
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-1891
Mailing Address - Country:US
Mailing Address - Phone:330-800-0089
Mailing Address - Fax:330-800-0177
Practice Address - Street 1:4466 DARROW RD STE 23
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-1891
Practice Address - Country:US
Practice Address - Phone:330-800-0089
Practice Address - Fax:330-800-0177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty