Provider Demographics
NPI:1407801954
Name:MATINIDES, CHRIS P (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:P
Last Name:MATINIDES
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 1:6535 MARKET AVE N
Mailing Address - Street 2:SUITE #105
Mailing Address - City:N CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44721-2487
Mailing Address - Country:US
Mailing Address - Phone:330-433-0333
Mailing Address - Fax:330-433-0785
Practice Address - Street 1:6535 MARKET AVE N
Practice Address - Street 2:SUITE #105
Practice Address - City:N CANTON
Practice Address - State:OH
Practice Address - Zip Code:44721-2487
Practice Address - Country:US
Practice Address - Phone:330-433-0333
Practice Address - Fax:330-433-0785
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-01-85281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice