Organization
MARK E. LOVE DMD ,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK EDWIN LOVE DMD (DENTIST)
(256) 332-6073
Entity
Organization
Contact information
Practice address
510 ENGLE DR SE, RUSSELLVILLE, AL 35653-2749
(256) 332-6073
(256) 332-6655
Mailing address
510 ENGLE DR SE, RUSSELLVILLE, AL 35653-2749
(256) 332-6073
(256) 332-6655
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3951
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
63-11104550
—
AL
Enumeration date
12/19/2017
Last updated
12/19/2017
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