Individual
DR. MARK CHRISTOPHER AZAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
3540 N BELT W, SUITE D, BELLEVILLE, IL 62226-5975
(618) 235-3337
(618) 235-8703
Mailing address
3540 N BELT W, SUITE D, BELLEVILLE, IL 62226-5975
(618) 235-3337
(618) 235-8703
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
19-A15099
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19-A15099
STATE SPECIALTY LICENSE
IL
Enumeration date
02/28/2007
Last updated
07/08/2007
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