Organization
MARDIS FAMILY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA MARIE MARDIS (OFFICE MANAGER)
(330) 836-7991
Entity
Organization
Contact information
Practice address
55 S MILLER RD STE 104, FAIRLAWN, OH 44333-4167
(330) 836-7991
(330) 836-8064
Mailing address
55 S MILLER RD STE 104, FAIRLAWN, OH 44333-4167
(330) 836-7991
(330) 836-8064
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30.023452
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235424227
NPI
—
Enumeration date
09/01/2017
Last updated
07/21/2022
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