Individual
DR. MARK STEPHEN ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4205 E HIGHWAY 66, DENTAL CLINIC, EL RENO, OK 73036-9701
(405) 319-7541
(405) 319-7675
Mailing address
4205 E HIGHWAY 66, PO BOX 1000, EL RENO, OK 73036-9701
(405) 319-7541
(405) 319-7675
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4511
OK
Other
Enumeration date
08/19/2013
Last updated
08/19/2013
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