Provider Demographics
NPI:1528074382
Name:CORTESI, GARY J (DDS)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:J
Last Name:CORTESI
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 1:1575 CORPORATE WOODS PKWY
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-7842
Mailing Address - Country:US
Mailing Address - Phone:330-896-5770
Mailing Address - Fax:330-896-2568
Practice Address - Street 1:1575 CORPORATE WOODS PKWY
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-7842
Practice Address - Country:US
Practice Address - Phone:330-896-5770
Practice Address - Fax:330-896-2568
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300146531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice