| Organization Name: | TIARA ENTERPRISE GROUP, INC |
| NPI Number: | 1003147752 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES MICHAEL PELAGALLI (MEMBER) |
| Mailing Address: | 12821 State Rd North Royalton |
| State: | OH US |
| Postal Code: | 441333911 |
| Phone Number: | 4402309401 |
| Fax Number: | |
| NPI Enumeration Date: | 01/20/2010 |
| NPI Last Update Date: | 06/15/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 17970 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |