Individual
DR. MARK WINSLOW ICARD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5500 HIGHWAY 49 S, SUITE 500, HARRISBURG, NC 28075-8414
(704) 455-5003
(704) 455-3587
Mailing address
5500 HIGHWAY 49 S, SUITE 500, HARRISBURG, NC 28075-8414
(704) 455-5003
(704) 455-3587
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5668
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8994419
—
NC
01
—
94419
BCBS PROVIDER ID
NC
Enumeration date
06/21/2006
Last updated
07/08/2007
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