Mark G Prusacki DDS

NPI 1467667071 - Dentist - 1223G0001X

NPI Details
NPI 1467667071
Gender Male
Enumeration Date 05/14/2007
Last Updated 06/27/2013
Entity Type Individual
Active Over 9 years ago
Practice Location
16415 S 46TH WAY
PHOENIX AZ, 85048-0158, US
Phone (480) 567-4212
Fax
Business Location
16415 S 46TH WAY
PHOENIX AZ, 85048-0158, US
Phone (480) 753-0529
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Arizona
License Number 4705
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According to our database, Dr. Mark G Prusacki DDS NPI is 1467667071, taxonomy code is 1223G0001X and license number is 4705, license state is located at Arizona. Mark G Prusacki DDS physically located at 16415 S 46th Way, Phoenix AZ, 85048-0158. NPI Number Mark G Prusacki DDS has the Individual type.

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1467667071 NPI number is provided on an as is basis without warranty of any kind. 1467667071 is maintained by the National Plan & Provider Enumeration System. The contents of Mark G Prusacki DDS are for informational purposes only.