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General NPI Number Information
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NPI Number | 1841777547
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Entity Type | Individual
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Provider Name | MARK HENRY NAGORKA D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2018
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 4774 MUNSON ST NW STE 102
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City | CANTON
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State | OH
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Zip | 44718-3634
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Country | US
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Telephone | 330-494-6653
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Fax | 330-494-6630
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Provider Business Mailing Address
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Address Line | 721 MOORE RD STE 304B
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City | AKRON
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State | OH
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Zip | 44319-5218
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Country | US
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Telephone | 248-705-6145
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 30.028086
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License Number State | OH
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