Individual
MARK MCGILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
602 E NOB HILL BLVD, YAKIMA, WA 98901-3534
(509) 248-3334
(509) 453-6144
Mailing address
PO BOX 190, TOPPENISH, WA 98948-0190
(509) 865-2395
(509) 865-5783
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE00007332
WA
1223G0001X
General Practice Dentistry
7332
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1037060
—
WA
Enumeration date
10/28/2010
Last updated
12/10/2024
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