Individual
DR. MARK KEYAN TADRISSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
14135 BALNTYN CORP PL STE 215, CHARLOTTE, NC 28277-4452
(704) 541-7017
Mailing address
14135 BALNTYN CORP PL STE 215, CHARLOTTE, NC 28277-4452
(704) 541-7017
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
9377
NC
1223G0001X
General Practice Dentistry
Primary
3086
NV
Other
Enumeration date
07/04/2006
Last updated
06/23/2026
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