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Organization
MARK O MANOUKIAN DENTAL CORP
Active
Organization
MARK O MANOUKIAN DENTAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAELA MUNIZ (VP, PAYOR RELATIONS)
(469) 324-3242
Entity
Organization
Contact information
Practice address
655 REDWOOD HWY FRONTAGE RD STE 120, MILL VALLEY, CA 94941-3068
(415) 383-1200
(415) 383-1500
Mailing address
655 REDWOOD HWY FRONTAGE RD STE 120, MILL VALLEY, CA 94941-3068
(415) 383-1200
(415) 383-1500
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
09/07/2026
Last updated
09/07/2026
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