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Individual

MR. MARK C YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS INC

Contact information

Practice address
314 SO 12TH AVE, SUITE #3, YAKIMA, WA 98902-3149
(509) 453-4504
(509) 573-4941
Mailing address
314 SO 12TH AVE, SUITE #3, YAKIMA, WA 98902-3149
(509) 453-4504
(509) 573-4941

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6244
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0595
WASHINGTON DENTAL SERVICE
WA
01
207871100000
PREMERA BLUE CROSS
WA
Enumeration date
08/31/2006
Last updated
07/08/2007
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