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Individual

MICHAEL MARK

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1 WASHINGTON SQ, NEW BRITAIN, CT 06051-1848
(860) 224-3642
(860) 826-5557
Mailing address
635 MAIN ST, MIDDLETOWN, CT 06457-2718
(860) 347-6971
(860) 638-6601

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
006957
CT

Other

Enumeration date
07/07/2005
Last updated
07/08/2007
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