Mardis Family Dental, Llc | |
55 S Miller Rd Ste 104 Fairlawn OH 44333-4167 | |
(330) 836-7991 | |
(330) 836-8064 |
Full Name | Mardis Family Dental, Llc |
---|---|
Speciality | Dentist |
Location | 55 S Miller Rd Ste 104, Fairlawn, Ohio |
Authorized Official Name and Position | Lisa Marie Mardis (OFFICE MANAGER) |
Authorized Official Contact | 3308367991 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Mardis Family Dental, Llc 55 S Miller Rd Ste 104 Fairlawn OH 44333-4167 Ph: (330) 836-7991 | Mardis Family Dental, Llc 55 S Miller Rd Ste 104 Fairlawn OH 44333-4167 Ph: (330) 836-7991 |
NPI Number | 1871011577 |
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Provider Enumeration Date | 09/01/2017 |
Last Update Date | 07/21/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871011577 | NPI | - | NPPES |
1235424227 | Other | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 30.023452 (Ohio) | Primary |
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