Organization
L MARK MILDE DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS MARK MILDE DDS (DR L MARK MILDE DDS PRESIDENT)
(573) 238-3330
Entity
Organization
Contact information
Practice address
101 FIRST ST, MARBLE HILL, MO 63764
(573) 238-3330
(573) 238-3464
Mailing address
PO BOX 650, MARBLE HILL, MO 63764
(573) 238-3330
(573) 238-3464
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12724
MO
Other
Enumeration date
10/10/2006
Last updated
08/22/2020
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