Individual
DR. MARK E HAVERKORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
5418 N LOOP 1604 E, SUITE 101, SAN ANTONIO, TX 78249-5463
(210) 778-0002
Mailing address
5418 N LOOP 1604 E, SUITE 101, SAN ANTONIO, TX 78249-5463
(210) 778-0002
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
23739
TX
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
N4460
TX
Other
Enumeration date
05/23/2007
Last updated
10/11/2018
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