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Individual

MARK WARNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2005 KNIGHT LANE BLDG H, NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAFF SVCS, JACKSONVILLE, FL 32212-0140
(760) 725-3213
Mailing address
1175 HART AVE., BRANCH DENTAL CLINIC YUMA, YUMA, AZ 85369

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7136-15
WI

Other

Enumeration date
09/21/2016
Last updated
09/21/2016
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