Provider Demographics
NPI:1740156819
Name:CANTON SOUTH DENTAL, COOK, ROTOLO & EARICH, LLC
Entity type:Organization
Organization Name:CANTON SOUTH DENTAL, COOK, ROTOLO & EARICH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:EARICH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:330-484-6401
Mailing Address - Street 1:3702 CLEVELAND AVE S
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44707-1450
Mailing Address - Country:US
Mailing Address - Phone:330-484-6401
Mailing Address - Fax:
Practice Address - Street 1:3702 CLEVELAND AVE S
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44707-1450
Practice Address - Country:US
Practice Address - Phone:330-484-6401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty