Provider Demographics
NPI:1003244005
Name:CUETO, CHELSEY KATHERINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHELSEY
Middle Name:KATHERINE
Last Name:CUETO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8839 SCOTSLANDING CIR NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-1207
Mailing Address - Country:US
Mailing Address - Phone:330-806-8763
Mailing Address - Fax:
Practice Address - Street 1:6451 FRANK AVE NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-8412
Practice Address - Country:US
Practice Address - Phone:330-806-8763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-023726122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist