Individual
DR. MARK A. HABLITZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
304 MADISON ST, PORT CLINTON, OH 43452-1937
(419) 734-2175
Mailing address
304 MADISON ST, PORT CLINTON, OH 43452-1937
(419) 734-2175
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13885
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0405056
—
OH
Enumeration date
08/30/2010
Last updated
08/31/2010
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