Individual
DR. MARK EDWARD DONICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
313 LIBERTY ST, WARREN, PA 16365-5709
(814) 723-3454
Mailing address
313 LIBERTY ST, WARREN, PA 16365-5709
(814) 723-3454
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS021425L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00054907
—
PA
Enumeration date
07/18/2006
Last updated
07/09/2007
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