Provider Demographics
NPI:1336288190
Name:FIXARI DENTAL OF CANAL LLC
Entity Type:Organization
Organization Name:FIXARI DENTAL OF CANAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FIXARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-834-3455
Mailing Address - Street 1:6441 WINCHESTER BLVD
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-2033
Mailing Address - Country:US
Mailing Address - Phone:614-834-3455
Mailing Address - Fax:614-834-3457
Practice Address - Street 1:6441 WINCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-2033
Practice Address - Country:US
Practice Address - Phone:614-834-3455
Practice Address - Fax:614-834-3457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty