Individual
DR. MARK JOHN CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
911 E STATE ST, SUITE C, SAINT JOHNS, MI 48879-1684
(989) 224-2379
Mailing address
911 E STATE ST, SUITE C, SAINT JOHNS, MI 48879-1684
(989) 224-2379
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13432
MI
Other
Enumeration date
06/30/2006
Last updated
07/08/2007
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