Individual
DR. MARK D DAMRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2800 PEOPLES ST STE 90, JOHNSON CITY, TN 37604-4158
(423) 928-0345
(423) 926-4358
Mailing address
2800 PEOPLES ST STE 90, JOHNSON CITY, TN 37604-4158
(423) 928-0345
(423) 926-4358
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401412183
VA
1223G0001X
General Practice Dentistry
8818
KY
1223G0001X
General Practice Dentistry
Primary
DS0000009838
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100104540
—
KY
Enumeration date
08/12/2008
Last updated
05/03/2019
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