Individual
DR. MARK TRACY DEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4886 SOCASTEE BLVD, MYRTLE BEACH, SC 29588-7245
(843) 293-1555
Mailing address
4886 SOCASTEE BLVD, MYRTLE BEACH, SC 29588-7245
(843) 293-1555
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
679
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D06795
—
SC
Enumeration date
03/16/2006
Last updated
08/16/2011
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