Individual
DR. MARK A PLANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, PA
Contact information
Practice address
2064 WASHINGTON ST N, TWIN FALLS, ID 83301-3071
(208) 734-1097
(208) 735-5160
Mailing address
2064 WASHINGTON ST N, TWIN FALLS, ID 83301-3071
(208) 734-1097
(208) 735-5160
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D-3129-OS
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002577900
—
ID
01
—
534917
UNITED CONCORDIA
ID
01
—
6D626
BLUE CROSS OF IDAHODENTAL
ID
01
—
6M048
BLUE CROSS OF IDAHO MED
ID
01
—
BLUE SHIELD
45250
ID
Enumeration date
08/01/2006
Last updated
11/01/2022
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