Individual
DR. WESLEY RAY MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
320 W BRISTOL ST, ELKHART, IN 46514-3085
(574) 266-6107
Mailing address
320 W BRISTOL ST, ELKHART, IN 46514-3085
(574) 266-6107
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12008923
IN
122300000X
Dentist
D10235
MN
Other
Enumeration date
08/26/2006
Last updated
07/08/2007
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