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Individual

DR. MARK L BROOKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
6060 PORTAL WAY, FERNDALE, WA 98248-7833
(360) 676-6177
(360) 671-3574
Mailing address
1616 CORNWALL AVE STE 205, BELLINGHAM, WA 98225-4642
(360) 676-6177
(360) 671-3574

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00007647
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0174704
LABOR AND INDUSTRIES
WA
05
5024534
WA
01
5877BR
REGENCE BLUE SHIELD
WA
Enumeration date
10/27/2006
Last updated
05/21/2020
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