Individual
MARK DENNIS CZARNECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1615 E 12TH ST, STE 100, THE DALLES, OR 97058-8004
(541) 296-1919
(541) 296-2253
Mailing address
PO BOX 1580, THE DALLES, OR 97058-8004
(541) 296-1919
(541) 296-2253
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15400DO
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152934
—
OR
Enumeration date
03/09/2007
Last updated
07/08/2007
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