Individual
MARK DWAIN FENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
8548 BEECHMONT AVE, CINCINNATI, OH 45255-4708
(513) 474-0122
(513) 474-1376
Mailing address
375 INDIAN RIPPLE ROAD, WILMINGTON, OH 45177
(937) 383-2410
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4191
OH
Other
Enumeration date
03/24/2006
Last updated
02/13/2012
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