Individual
MARK RICHARD PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11503 SUNRISE VALLEY DR, RESTON, VA 20191
(703) 860-3200
(703) 476-6794
Mailing address
18708 OLNEY MILL RD, OLNEY, MD 20832
(301) 260-1571
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401008179
VA
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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