Individual
DR. MARK EDWIN FLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
300 NW RR MIZE RD, SUITE 100, BLUE SPRINGS, MO 64014-2528
(816) 229-3737
(816) 229-1656
Mailing address
5457 NE WEDGEWOOD LN, LEES SUMMIT, MO 64064-1223
(816) 373-7968
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12700
MO
Other
Enumeration date
07/21/2006
Last updated
07/09/2007
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