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Individual

MARK RICHARD SARDO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
2323 PARKWOOD DR, BRUNSWICK, GA 31520-4720
(912) 265-7193
(912) 265-6799
Mailing address
2323 PARKWOOD DR, BRUNSWICK, GA 31520-4720
(912) 265-7193
(912) 265-6799

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
010170
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
821940
UNITED CONCORDIA PROVIDER
GA
Enumeration date
05/09/2007
Last updated
07/08/2007
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