Provider Demographics
NPI:1194892695
Name:SANTO, ELIZABETH J (DDS)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:J
Last Name:SANTO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4354 VALLEY FORGE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-2825
Mailing Address - Country:US
Mailing Address - Phone:440-333-5594
Mailing Address - Fax:440-846-2496
Practice Address - Street 1:13550 FALLING WATER RD
Practice Address - Street 2:SUITE 103
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-4360
Practice Address - Country:US
Practice Address - Phone:440-238-1946
Practice Address - Fax:440-846-2496
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH202361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice