Individual
DR. SCOT C. MARDIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1616 N 9TH ST, TERRE HAUTE, IN 47804-2841
(812) 232-8361
(812) 238-9406
Mailing address
1616 N 9TH ST, TERRE HAUTE, IN 47804-2841
(812) 232-8361
(812) 238-9406
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12008116A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
777790
UNITED CONCORDIA
—
Enumeration date
02/23/2006
Last updated
07/08/2007
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