Organization
DONALD D. MARDIS, DDS, PA
Active
Parent organization
DONALD D. MARDIS, DDS, PA
Other names
Quivira Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
DONALD D. MARDIS, DDS, PA
Authorized official
LORI EDMONDS (CREDENTIALING COORDINATOR)
(217) 540-8468
Entity
Organization
Contact information
Practice address
7450 QUIVIRA RD, SHAWNEE MISSION, KS 66216-3526
(913) 217-7536
Mailing address
7450 QUIVIRA RD, SHAWNEE MISSION, KS 66216-3526
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/18/2014
Last updated
09/02/2016
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