# DR. MARK ARTHUR DETTELBACH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1467425546
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | D47278 | MD | — |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | MD21258 | DC | Yes |

## Other

- **Enumeration date:** 02/09/2006
- **Last updated:** 06/26/2025