NPI Registry.org

Justin Mackert

NPI Registration Record

Provider / OrganizationNPIDate Certified
JUSTIN MACKERT15286853692020-06-27
Entity TypeIndividual
Provider Name Justin Mackert DMD
Practice Office Address15711 MADISON AVE STE 104
LAKEWOOD, OH US
Practice Office Telephone4408233175
Practice Office Fax2162287951
Mailing Address15711 MADISON AVE STE 104
LAKEWOOD, OH 441075655 US
Business Telephone4408233175
Contact Endpoints
[email protected] [][email protected]Direct
HPT Codes
CodeLicense NoState
1223G0001X PRIMARY30.026215 OH
OPI Codes
30.026215 OTHER OH DENTAL LICENSE

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