Individual
MR. MARK LOUIS MILTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EFDA, RDA
Contact information
Practice address
14406 NE 20TH AVE, VANCOUVER, WA 98686-1448
(360) 571-3139
Mailing address
4100 NE 51ST ST, VANCOUVER, WA 98661-2704
(360) 608-7911
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
116505
OR
126800000X
Dental Assistant
Primary
D160053453
WA
Other
Enumeration date
12/10/2012
Last updated
12/10/2012
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