Organization
MARK S MEDEL DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK S MEDEL DDS ORAL AND MAXILLO (OWNER)
(989) 723-3882
Entity
Organization
Contact information
Practice address
208 N SHIAWASSEE ST, OWOSSO, MI 48831
(989) 723-3882
(989) 729-1723
Mailing address
208 N SHIAWASSEE ST, OWOSSO, MI 48831
(989) 723-3882
(989) 729-1723
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
MM13787
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9757860390
BCBS
MI
Enumeration date
09/19/2007
Last updated
12/21/2007
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