Individual
MITCHELL A STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
14955 SHADY GROVE RD, SUITE 330, ROCKVILLE, MD 20850
(301) 340-0101
(301) 340-1689
Mailing address
14955 SHADY GROVE RD, SUITE 330, ROCKVILLE, MD 20850
(301) 340-0101
(301) 340-1689
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
11426
MD
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DEN5790
DC
Other
Enumeration date
10/18/2006
Last updated
07/08/2007
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