Individual
DR. MARK ALAN RALPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
400 E DIAMOND AVE, EVANSVILLE, IN 47711-3714
(812) 461-2365
(812) 461-2366
Mailing address
2353 WHITESBURG DRIVE, HUNTSVILLE, AL 35801
(256) 533-3735
(256) 533-3780
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4813
AL
1223G0001X
General Practice Dentistry
Primary
12012871A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5151085
BLUE CROSS
AL
Enumeration date
10/12/2006
Last updated
03/17/2018
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