Organization
MARK T MENTZER OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK THOMAS MENTZER OD (PRESIDENT)
(319) 294-9546
Entity
Organization
Contact information
Practice address
2200 BLAIRSFERRY CROSSING, HIAWATHA, IA 52233
(319) 294-9546
(319) 395-0089
Mailing address
2200 BLAIRSFERRY CROSSING, HIAWATHA, IA 52233
(319) 294-9546
(319) 395-0089
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
01912
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0203241
—
IA
Enumeration date
04/14/2006
Last updated
04/08/2009
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