Individual
EDWARD T MAMARIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4027 S LAFOUNTAIN ST, KOKOMO, IN 46902-6913
(765) 453-9389
(765) 453-9369
Mailing address
4027 S LAFOUNTAIN ST, KOKOMO, IN 46902-6913
(765) 453-9389
(765) 453-9369
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12008594A
IN
Other
Enumeration date
12/05/2006
Last updated
03/28/2024
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