Individual
MARK CLIFFORD TINNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
9020 W JUDGE PEREZ DR, CHALMETTE, LA 70043-4500
(504) 277-4401
Mailing address
520 PHYLLIS DR, COVINGTON, LA 70433-4222
15042285988
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6757
LA
Other
Enumeration date
05/22/2017
Last updated
03/17/2018
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