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Individual
DR. MARK DOUGLAS MINTLINE
Active
Individual
DR. MARK DOUGLAS MINTLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
62702
CA
1223P0106X
Oral and Maxillofacial Pathology Dentistry
62702
CA
1223P0106X
Oral and Maxillofacial Pathology Dentistry
DS045628
PA
Other
Enumeration date
08/01/2013
Last updated
09/10/2026
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