Individual
MARK CONOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
44100 JEFFERSON ST # 506, INDIO, CA 92201-9014
(951) 217-4625
Mailing address
30975 E SUNSET DR S, REDLANDS, CA 92373-7449
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
28914
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DD3892
NM
Other
Enumeration date
02/24/2015
Last updated
01/07/2021
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