Mark Glenn Maddox DDS

NPI 1679732432 - Dentist - 122300000X

NPI Details
NPI 1679732432
Gender Male
Enumeration Date 06/06/2008
Last Updated 06/06/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
18400 CHESTNUT ST
TUOLUMNE CA, 95379, US
Phone (209) 928-4262
Fax
Business Location
PO BOX 897
TUOLUMNE CA, 95379, US
Phone (209) 928-4262
Fax
Toxanomy
Taxonomy Code 122300000X
License State California
License Number 23849D
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According to our database, Mr. Mark Glenn Maddox DDS NPI is 1679732432, taxonomy code is 122300000X and license number is 23849D, license state is located at California. Mark Glenn Maddox DDS physically located at 18400 Chestnut St, Tuolumne CA, 95379. NPI Number Mark Glenn Maddox DDS has the Individual type.

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1679732432 NPI number is provided on an as is basis without warranty of any kind. 1679732432 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Glenn Maddox DDS are for informational purposes only.