Individual
DR. MARK RICHARD OBLAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
14155 N 83RD AVE STE 141, PEORIA, AZ 85381-5652
(623) 878-1000
(623) 878-1024
Mailing address
14155 N 83RD AVE STE 141, PEORIA, AZ 85381-5652
(623) 878-1000
(623) 878-1024
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4943072-9921
UT
1223E0200X
Endodontics
Primary
7744
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
445670
—
AZ
Enumeration date
01/25/2006
Last updated
02/04/2015
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