# MARK S MACDONALD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114906781
- **Authorized official:** MARK STEVEN MACDONALD DDS (PRESIDENT OWNER)
- **Authorized official phone:** (313) 563-2522

## Contact information

- **Practice address:** 22944 W OUTER DR, DEARBORN, MI 48124
- **Practice address phone:** (313) 563-2522
- **Practice address fax:** (313) 563-2522
- **Mailing address:** 22944 W OUTER DR, DEARBORN, MI 48124
- **Mailing address phone:** (313) 563-2522
- **Mailing address fax:** (313) 563-2522

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2901014432 | MI | Yes |

## Other

- **Enumeration date:** 01/12/2006
- **Last updated:** 08/22/2020