Individual
DR. MARK A RUNYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
100 4TH ST S STE 312, FARGO, ND 58103-1937
(701) 232-2409
(701) 232-2563
Mailing address
100 4TH ST S STE 312, FARGO, ND 58103-1937
(701) 232-2409
(701) 232-2563
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2262
ND
Other
Enumeration date
06/09/2015
Last updated
06/09/2015
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