Organization
MARK R DRIVER DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK DRIVER (OWNER)
(541) 672-8187
Entity
Organization
Contact information
Practice address
1651 NW HUGHWOOD COURT, ROSEBURG, OR 97471-8834
(541) 672-8187
Mailing address
1651 NW HUGHWOOD CT, ROSEBURG, OR 97471-8834
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
OR
Other
Enumeration date
07/26/2011
Last updated
07/26/2011
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