Organization
JOHN MASCARO D M D M D AND CARL CHOI D D S M D INC
Active
Other names
Great Lakes Jaw and Implant Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MASCARO D M D M D (PRESIDENT)
(440) 946-2247
Entity
Organization
Contact information
Practice address
4230 STATE ROUTE 306 STE 350, WILLOUGHBY, OH 44094-9213
(440) 946-2247
(440) 946-3530
Mailing address
4230 STATE ROUTE 306 STE 350, WILLOUGHBY, OH 44094-9213
(440) 946-2247
(440) 946-3530
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
01/09/2008
Last updated
06/16/2010
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