Individual
GREGORY MARK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6509 99TH ST, SUITE D, REGO PARK, NY 11374-3570
(718) 275-9792
(718) 997-8362
Mailing address
6761 110TH ST, FOREST HILLS, NY 11375-2943
(718) 268-0458
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
046175
NY
Other
Enumeration date
10/19/2005
Last updated
07/08/2007
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