# MARK S MEDEL DDS PC

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

## Provider details

- **NPI number:** 1598951055
- **Authorized official:** DR. MARK S MEDEL DDS ORAL AND MAXILLO (OWNER)
- **Authorized official phone:** (989) 723-3882

## Contact information

- **Practice address:** 208 N SHIAWASSEE ST, OWOSSO, MI 48831
- **Practice address phone:** (989) 723-3882
- **Practice address fax:** (989) 729-1723
- **Mailing address:** 208 N SHIAWASSEE ST, OWOSSO, MI 48831
- **Mailing address phone:** (989) 723-3882
- **Mailing address fax:** (989) 729-1723

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | MM13787 | MI | Yes |

## Other

- **Enumeration date:** 09/19/2007
- **Last updated:** 12/21/2007