Provider Demographics
NPI:1225291446
Name:CUETO, ISAAC ELIAS (DDS)
Entity Type:Individual
Prefix:
First Name:ISAAC
Middle Name:ELIAS
Last Name:CUETO
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 1:2300 GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-5334
Mailing Address - Country:US
Mailing Address - Phone:330-262-1121
Mailing Address - Fax:330-264-3711
Practice Address - Street 1:2300 GATEWAY DR
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-5334
Practice Address - Country:US
Practice Address - Phone:330-262-1121
Practice Address - Fax:330-264-3711
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-023032122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist