Provider Demographics
NPI:1942263447
Name:PETROFF, CYNTHIA J (DDS)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:J
Last Name:PETROFF
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CYNTHIA
Other - Middle Name:J
Other - Last Name:MARSHALL-PETROFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:3725 CLEVELAND MASSILLON RD
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-5614
Mailing Address - Country:US
Mailing Address - Phone:330-825-0818
Mailing Address - Fax:330-825-2186
Practice Address - Street 1:3725 CLEVELAND MASSILLON RD
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:OH
Practice Address - Zip Code:44203-5614
Practice Address - Country:US
Practice Address - Phone:330-825-0818
Practice Address - Fax:330-825-2186
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH179611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice