Individual
DR. MARK ROBERT DETERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
919 SOUTH STATE ROAD 2, HEBRON, IN 46341-9539
(219) 996-4171
Mailing address
919 SOUTH STATE ROAD 2, HEBRON, IN 46341-9539
(219) 996-4171
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7849
IN
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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