Individual
MARK AUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2100 SE 164TH AVE., SUITE D102, VANCOUVER, WA 98683
(360) 882-1647
Mailing address
2100 SE 164TH AVE., SUITE D102, VANCOUVER, WA 98683
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE8705
WA
Other
Enumeration date
05/30/2013
Last updated
05/30/2013
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