Provider Demographics
NPI:1255412748
Name:DENTISTRY INC
Entity type:Organization
Organization Name:DENTISTRY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GINO
Authorized Official - Middle Name:GIANNI
Authorized Official - Last Name:DIGIANNANTONIO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:440-943-2323
Mailing Address - Street 1:27291 CHARDON RD
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44092
Mailing Address - Country:US
Mailing Address - Phone:443-943-2323
Mailing Address - Fax:442-943-2414
Practice Address - Street 1:27291 CHARDON RD
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44092
Practice Address - Country:US
Practice Address - Phone:443-943-2323
Practice Address - Fax:442-943-2414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20444122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty