Individual
DR. MARK D. DANIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1550 NW EASTMAN PARKWAY, #265, GRESHAM, OR 97030
(503) 665-0495
Mailing address
1550 NW EASTMAN PARKWAY, #265, GRESHAM, OR 97030
(503) 665-0495
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
D6548
OR
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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