Individual
DR. MARK J NOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4504 PARNELL AVE, FORT WAYNE, IN 46825-5836
(269) 048-2838
Mailing address
4504 PARNELL AVE, FORT WAYNE, IN 46825-5836
(269) 048-2838
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010479A
IN
Other
Enumeration date
06/08/2007
Last updated
07/08/2007
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