Individual
MARK A HANDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
401 N MAIN ST, GRAVOIS MILLS, MO 65037-6253
(877) 406-2662
(573) 207-2773
Mailing address
PO BOX 777, RICHLAND, MO 65556-0777
(573) 708-7600
(573) 723-1474
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2014006645
MO
1223G0001X
General Practice Dentistry
6311
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043231806
—
KS
05
—
1043231806
—
MO
Enumeration date
07/21/2006
Last updated
05/08/2023
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