MEDICARE: DR. MARK J NOLL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12010479A	IN

General Provider Information

NPI Number	:	1356544027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK J NOLL

Provider Business Mailing Address
First Line	:	4504 PARNELL AVE
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-5836
Country	:	US
Telephone Number	:	269-048-2838
Fax Number	:

Provider Business Practice Location Address
First Line	:	4504 PARNELL AVE
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-5836
Country	:	US
Telephone Number	:	269-048-2838
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1295871739 — DR. DAVID M. ALLEN D.D.S.
Practice Location Address:

4504 PARNELL AVE
FORT WAYNE, IN
46825-5836

Practice Phone: 260-482-8386
Practice Fax: 260-483-0024

1831392521 — MARK DANKOWSKI
Practice Location Address:

4504 PARNELL AVE
FORT WAYNE, IN
46825-5836

Practice Phone: 260-482-8386
Practice Fax:

1063724805 — DR. SURESH KUMAR VARMA VEGESANA D.D.S.
Practice Location Address:

4512 PARNELL AVE
FORT WAYNE, IN
46825-5836

Practice Phone: 260-399-1333
Practice Fax: 260-755-3271

1386062768 — LAKEWOOD FAMILY DENTAL INC
Practice Location Address:

4512 PARNELL AVE
FORT WAYNE, IN
46825-5836

Practice Phone: 732-379-0953
Practice Fax:

1346802527 — MANSIMRAN SANDHU
Practice Location Address:

4512 PARNELL AVE
FORT WAYNE, IN
46825-5836

Practice Phone: 260-238-8899
Practice Fax:

1326777814 — YAGNA ROOPA KASARANENI
Practice Location Address:

4512 PARNELL AVE
FORT WAYNE, IN
46825-5836

Practice Phone: 260-238-8899
Practice Fax:

Directions to “ DR. MARK J NOLL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.