Provider Demographics
NPI:1245329515
Name:MARDAGA, WILLIAM J (DDS,MS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:MARDAGA
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4850 W PANTHER CREEK DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-3607
Mailing Address - Country:US
Mailing Address - Phone:281-367-7775
Mailing Address - Fax:281-367-1247
Practice Address - Street 1:4850 W PANTHER CREEK DR
Practice Address - Street 2:SUITE 108
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-3607
Practice Address - Country:US
Practice Address - Phone:281-367-7775
Practice Address - Fax:281-367-1247
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX109901223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics