Provider Demographics
NPI:1144305608
Name:FARIAN, MARKO ROMAN (DDS)
Entity type:Individual
Prefix:DR
First Name:MARKO
Middle Name:ROMAN
Last Name:FARIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 E AURORA ROAD
Mailing Address - Street 2:
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056
Mailing Address - Country:US
Mailing Address - Phone:330-468-0980
Mailing Address - Fax:330-468-2181
Practice Address - Street 1:503 E AURORA ROAD
Practice Address - Street 2:
Practice Address - City:MACEDONIA
Practice Address - State:OH
Practice Address - Zip Code:44056
Practice Address - Country:US
Practice Address - Phone:330-468-0980
Practice Address - Fax:330-468-2181
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30021589122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist