Individual
ELLEN MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6399 GARFIELD AVE, SUITE 150, SACRAMENTO, CA 95841
(916) 344-1000
Mailing address
PO BOX 72866, DAVIS, CA 95617-2866
(530) 756-5060
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
57132
CA
Other
Enumeration date
08/20/2008
Last updated
08/20/2008
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