Individual
DR. STEPHEN T CAROSELLO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9500 MENTOR AVE, STE 280, MENTOR, OH 44060-8715
(440) 352-2887
(440) 352-7611
Mailing address
9500 MENTOR AVE, STE 280, MENTOR, OH 44060-8715
(440) 352-2887
(440) 352-7611
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30-01-4053
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0475481
—
OH
Enumeration date
05/24/2005
Last updated
07/08/2007
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