Provider Demographics
NPI:1659618544
Name:DAGER ORTHODONTICS
Entity Type:Organization
Organization Name:DAGER ORTHODONTICS
Other - Org Name:MARION ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:DAGER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:765-662-3881
Mailing Address - Street 1:1102 N WABASH AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-2510
Mailing Address - Country:US
Mailing Address - Phone:765-662-3881
Mailing Address - Fax:765-662-7090
Practice Address - Street 1:1102 N WABASH AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-2510
Practice Address - Country:US
Practice Address - Phone:765-662-3881
Practice Address - Fax:765-662-7090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty