Individual
DR. ALFRED SCOTT SANTUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
827 ROBBINS AVE, NILES, OH 44446-2431
(330) 652-2676
(330) 652-0994
Mailing address
827 ROBBINS AVE, NILES, OH 44446-2431
(330) 652-2676
(330) 652-0994
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18923
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0505422500027
CARESOURCE
OH
01
—
0638
GATEWAY
OH
05
—
0833334
—
OH
Enumeration date
03/02/2007
Last updated
07/08/2007
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