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Organization

R MARK OWENS DMD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT MARK OWENS DMD (OWNER)
(601) 939-2377
Entity
Organization

Contact information

Practice address
642 S PEARSON ROAD, PEARL, MS 39208
(601) 939-2377
(601) 939-2529
Mailing address
642 S PEARSON ROAD, PEARL, MS 39208
(601) 939-2377
(601) 939-2529

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
301197
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03650331
MS
01
425491211
BCBS OF MS
MS
01
902980
UNITED CONCORDIA
MS
Enumeration date
10/25/2006
Last updated
05/27/2011
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