Individual
MR. MARK D NELKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
196 RT 94, BLAIRSTOWN, NJ 07825-0650
(908) 362-8289
(908) 362-8289
Mailing address
PO BOX 650, BLAIRSTOWN, NJ 07825-0650
(908) 362-8289
(908) 362-8289
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D13392
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D13392
LISCENCE
NJ
Enumeration date
06/13/2007
Last updated
07/08/2007
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