Provider Demographics
NPI:1164681771
Name:NADOLNE, MARK S (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:S
Last Name:NADOLNE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E 42ND ST
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5678
Mailing Address - Country:US
Mailing Address - Phone:212-867-8862
Mailing Address - Fax:212-867-8402
Practice Address - Street 1:120 E 42ND ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5678
Practice Address - Country:US
Practice Address - Phone:212-867-8862
Practice Address - Fax:212-867-8402
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047883122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist