Mark L Connolly DMD

NPI 1053396259 - Dentist - 1223G0001X

NPI Details
NPI 1053396259
Gender Male
Enumeration Date 12/09/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
411 HIGH ST
MEDFORD MA, 02155-3610, US
Phone (781) 396-7707
Fax (781) 395-5035
Business Location
411 HIGH ST
MEDFORD MA, 02155-3610, US
Phone (781) 396-7707
Fax (781) 395-5035
Toxanomy
Taxonomy Code 1223G0001X
License State Massachusetts
License Number 13550
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According to our database, Dr. Mark L Connolly DMD NPI is 1053396259, taxonomy code is 1223G0001X and license number is 13550, license state is located at Massachusetts. Mark L Connolly DMD physically located at 411 High St, Medford MA, 02155-3610. NPI Number Mark L Connolly DMD has the Individual type.

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1053396259 NPI number is provided on an as is basis without warranty of any kind. 1053396259 is maintained by the National Plan & Provider Enumeration System. The contents of Mark L Connolly DMD are for informational purposes only.