Organization
MARK S. GRESKOVICH DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI BROCK (MGR)
(850) 477-1125
Entity
Organization
Contact information
Practice address
4850 N 9TH AVE STE 4, PENSACOLA, FL 32503-2406
(850) 477-1125
(850) 477-1125
Mailing address
4850 N 9TH AVE STE 4, PENSACOLA, FL 32503-2406
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN0011988
FL
Other
Enumeration date
03/23/2010
Last updated
03/23/2010
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