Provider Demographics
NPI:1770671117
Name:ALEMAGNO, MARIO E (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIO
Middle Name:E
Last Name:ALEMAGNO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6370 SOM CENTER RD.
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2964
Mailing Address - Country:US
Mailing Address - Phone:440-248-6823
Mailing Address - Fax:
Practice Address - Street 1:6370 SOM CENTER RD
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2964
Practice Address - Country:US
Practice Address - Phone:440-248-6823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH188031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice