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Organization
MARK D. DEBOCK DDS
Active
Organization
MARK D. DEBOCK DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK S DEBOCK DDS (OWNER)
(718) 238-0248
Entity
Organization
Contact information
Practice address
7500 4TH AVE STE A1, BROOKLYN, NY 11209-3209
(718) 238-0248
(630) 614-4627
Mailing address
7500 4TH AVE STE A1, BROOKLYN, NY 11209-3209
(718) 238-0248
(630) 614-4627
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01045312
—
NY
Enumeration date
08/12/2019
Last updated
08/12/2019
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