Cruise, Mark Alan

Cruise, Mark Alan is an individual health care provider with primary practice located at 640 12Th St Se , Salem OR 97301-4001. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Cruise, Mark Alan can be contacted via phone (503) 364-7944.

Contact Information

Primary practice address
640 12Th St Se Salem OR 97301-4001
Phone: (503) 364-7944
Fax: (503) 585-8902
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 6138 Oregon

Profile Details

NPI number 1295721645
LBN Legal business name Cruise, Mark Alan
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2005
Last updated Jul 8th, 2007 - about 19 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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