Individual
DR. MARC C VAN TASSELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1304 E AULTMAN ST, ELY, NV 89301-2513
(775) 289-6166
Mailing address
1304 E AULTMAN ST, ELY, NV 89301-2513
(775) 289-6166
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4743125-9922
UT
Other
Enumeration date
02/07/2006
Last updated
04/11/2016
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