Individual
MARK R SLYSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
103 OLD MARLTON PIKE, SUITE 200, MEDFORD, NJ 08055-8772
(609) 953-7123
Mailing address
103 OLD MARLTON PIKE, SUITE 200, MEDFORD, NJ 08055-8772
(609) 953-7123
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02315600
NJ
1223G0001X
General Practice Dentistry
DS027536L
PA
Other
Enumeration date
02/09/2007
Last updated
07/08/2007
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