Individual
MARK DWAYNE DYKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SFIDC
Contact information
Practice address
700 COLORADO DR, HEMET, CA 92544
(951) 927-9142
Mailing address
700 COLORADO DR, HEMET, CA 92544-7800
(951) 927-9142
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/25/2008
Last updated
04/25/2008
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