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Individual

DR. MARK RICHARD GLEISNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
2 ND FLOOR BLDG 9900, ATTN: CREDENTIALS OFFICE, TACOMA, WA 98431-0001
(253) 968-4039
Mailing address
2 ND FLOOR BLDG 9900, ATTN: CREDENTIALS OFFICE, TACOMA, WA 98431-0001
(253) 968-4039

Taxonomy

Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
5388-15
WI
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
D10642
MN

Other

Enumeration date
04/04/2006
Last updated
01/28/2010
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