# DR. JOHN ROBERT MASCARO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1619989654
- **Gender:** Man
- **Credential:** DMD MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 30019907 | OH | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 35066280 | OH | — |

## Other

- **Enumeration date:** 08/11/2006
- **Last updated:** 01/28/2008