Individual
MARK ALLEN VANZANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
203 BUSINESS CENTER LOOP STE C, KALISPELL, MT 59901-6885
(406) 752-4545
(406) 752-4405
Mailing address
203 BUSINESS CENTER LOOP STE C, KALISPELL, MT 59901-6885
(406) 752-4545
(406) 752-4405
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11504
MT
122300000X
Dentist
9527884-9922
UT
1223G0001X
General Practice Dentistry
DEN-DEN-LIC-11504
MT
1223G0001X
General Practice Dentistry
DN 16868
FL
Other
Enumeration date
09/12/2005
Last updated
08/24/2021
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