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Contact Information

JORDAN MAYBERRY, DDS
73 SPORTSMAN DR STE A
MARENGO, OH43334
 Phone: 419-253-3100
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for JORDAN MAYBERRY · (Male)

NPI # 1073047049
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 04/17/2017
Last updated 11/09/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 30.025048
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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