Individual
MARK J. TENNISWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
208 NE 3RD ST, OKEECHOBEE, FL 34972-2947
(863) 763-3909
(863) 467-0157
Mailing address
208 NE 3RD ST, OKEECHOBEE, FL 34972-2947
(863) 763-3909
(863) 467-0157
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN12820
FL
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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