Church, Mark Richard
Church, Mark Richard is an individual health care provider with primary practice located at 4431 68Th Street U S Army Dental Activity, Fort Hood TX 76544. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / Orthodontics and Dentofacial Orthopedics is his primary health care specialty. Church, Mark Richard can be contacted via phone (253) 495-1193.Contact Information
Primary practice address
4431 68Th Street U S Army Dental Activity
Fort Hood TX 76544
Phone: (253) 495-1193
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 8618 | Kentucky |
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 60884792 | Washington |
Profile Details
| NPI number | 1679733703 |
|---|---|
| LBN Legal business name | Church, Mark Richard |
| Credentials | DMD, MS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 12th, 2008 |
| Last updated | Dec 4th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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