Provider Demographics
NPI:1962426197
Name:CITRON, SHARON G (DMD)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:G
Last Name:CITRON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 MAYFIELD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2695
Mailing Address - Country:US
Mailing Address - Phone:216-382-5007
Mailing Address - Fax:216-382-5009
Practice Address - Street 1:5010 MAYFIELD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2695
Practice Address - Country:US
Practice Address - Phone:216-382-5007
Practice Address - Fax:216-382-5009
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH170551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice