Individual
MARK L. DAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
181 N KENTUCKY AVE, WEST PLAINS, MO 65775-2089
(417) 256-5100
(417) 257-0721
Mailing address
181 N KENTUCKY AVE, WEST PLAINS, MO 65775-2089
(417) 256-5100
(417) 257-0721
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
014271
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113039608
—
AR
05
—
1447260930
—
MO
Enumeration date
08/08/2006
Last updated
02/20/2013
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