# MARK A IACOBELLI D D S INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548369564
- **Authorized official:** MARK ANTHONY IACOBELLI DDS FAGD (PRESIDENT)
- **Authorized official phone:** (440) 845-7300

## Contact information

- **Practice address:** 8030 CORPORATE CIRCLE, NORTH ROYALTON, OH 44133-1245
- **Practice address phone:** (440) 845-7300
- **Practice address fax:** (440) 845-7785
- **Mailing address:** 8030 CORPORATE CIRCLE, NORTH ROYALTON, OH 44133-1245
- **Mailing address phone:** (440) 845-7300
- **Mailing address fax:** (440) 845-7785

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 17096 | OH | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |
| 122400000X | Denturist | — | NULL | — |
| 122400000X | Denturist | — | — | — |

## Other

- **Enumeration date:** 09/22/2006
- **Last updated:** 06/07/2023