Individual
DR. MARK T HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
318 ORCHARD SPRINGS DR, PUEBLO WEST, CO 81007
(719) 647-1122
(719) 647-1142
Mailing address
348 TEJON LN, PUEBLO WEST, CO 81007
(719) 647-1122
(719) 647-1142
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
106275
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
88834042
—
CO
Enumeration date
10/24/2006
Last updated
07/08/2007
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