Individual
DR. THADDEUS JUDE JOHN MANDATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
21245 LORAIN RD, SUITE 100, FAIRVIEW PARK, OH 44126-2146
(440) 331-0164
(440) 331-0165
Mailing address
21245 LORAIN RD, SUITE 100, FAIRVIEW PARK, OH 44126-2146
(440) 331-0164
(440) 331-0165
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30-01-5181
OH
Other
Enumeration date
09/14/2006
Last updated
07/08/2007
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