Individual
DR. MARK R FISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.
Contact information
Practice address
4901 LIMESTONE RD, WILMINGTON, DE 19808-1271
(302) 239-4600
(302) 239-9951
Mailing address
4901 LIMESTONE RD, WILMINGTON, DE 19808-1271
(302) 239-4600
(302) 239-9951
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
G10001167
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17695
—
DE
Enumeration date
03/20/2007
Last updated
07/08/2007
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