Individual
DR. W MARK DONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
204 N COLUMBUS AVE, LOUISVILLE, MS 39339-2614
(662) 773-8304
(663) 779-0667
Mailing address
204 N COLUMBUS AVE, LOUISVILLE, MS 39339-2614
(662) 773-8304
(663) 779-0667
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
240588
MS
Other
Enumeration date
05/20/2007
Last updated
07/08/2007
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