MEDICARE: MARC S ASMAR DDS

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	122300000X	Dentist	19739	OH

General Provider Information

NPI Number	:	1811143159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARC S ASMAR DDS

Provider Business Mailing Address
First Line	:	26924 COOK RD
Second Line	:	GREENBROOKE PLAZA
City	:	OLMSTED FALLS
State	:	OH
Zip	:	44138-1178
Country	:	US
Telephone Number	:	440-235-1180
Fax Number	:	440-235-7007

Provider Business Practice Location Address
First Line	:	26924 COOK RD
Second Line	:	GREENBROOKE PLAZA
City	:	OLMSTED FALLS
State	:	OH
Zip	:	44138-1178
Country	:	US
Telephone Number	:	440-235-1180
Fax Number	:	440-235-7007

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

Provider Enumeration Date	:	08/18/2008
Last Update Date	:	08/18/2008

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