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General NPI Number Information
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NPI Number | 1982876660
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Entity Type | Organization
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Legal Business Name | DOMENIC DINELLO DMD, INC.
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Dates
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Enumeration Date | 04/02/2008
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 116 EXCHANGE ST
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City | LISBON
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State | OH
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Zip | 44432-1402
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Country | US
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Telephone | 330-424-9024
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Fax | 330-424-5999
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Provider Business Mailing Address
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Address Line | 116 EXCHANGE ST
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City | LISBON
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State | OH
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Zip | 44432-1402
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Country | US
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Telephone | 330-424-9024
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Fax | 330-424-5999
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. DOMENIC DINELLO
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Credential | DMD
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Telephone | 330-424-9024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30020615
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License Number State | OH
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