Provider Demographics
NPI:1518131788
Name:LIONETTI, CHARLES T (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:T
Last Name:LIONETTI
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 1:5510 PEARL RD STE 301
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-2550
Mailing Address - Country:US
Mailing Address - Phone:440-845-8700
Mailing Address - Fax:
Practice Address - Street 1:5510 PEARL RD STE 301
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-2550
Practice Address - Country:US
Practice Address - Phone:440-845-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH16549122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist