Individual
MARK CUSHING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
15753 YODER AVE, CALDWELL, ID 83607-8313
(208) 989-9500
Mailing address
15753 YODER AVE, CALDWELL, ID 83607
(208) 989-9500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-3025
ID
Other
Enumeration date
11/20/2013
Last updated
11/20/2013
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