Individual
DR. CHARLES EDWARD MARDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
55 S MILLER RD, SUITE 104, FAIRLAWN, OH 44333-4166
(330) 836-7991
Mailing address
55 S MILLER RD, SUITE 104, FAIRLAWN, OH 44333-4166
(330) 836-7991
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30.023452
OH
Other
Enumeration date
06/17/2011
Last updated
06/17/2011
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