Mark Laverne Stafford DDS

NPI 1457516155 - Dentist - 1223G0001X

NPI Details
NPI 1457516155
Gender Male
Enumeration Date 07/22/2008
Last Updated 07/22/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
1460 7TH STREET
#205
SANTA MONICA CA, 90401, US
Phone (310) 393-8317
Fax (310) 458-8804
Business Location
1460 7TH STREET
#205
SANTA MONICA CA, 90401, US
Phone (310) 393-8317
Fax (310) 458-8804
Toxanomy
Taxonomy Code 1223G0001X
License State California
License Number 28986
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According to our database, Dr. Mark Laverne Stafford DDS NPI is 1457516155, taxonomy code is 1223G0001X and license number is 28986, license state is located at California. Mark Laverne Stafford DDS physically located at 1460 7th Street, Santa Monica CA, 90401. NPI Number Mark Laverne Stafford DDS has the Individual type.

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1457516155 NPI number is provided on an as is basis without warranty of any kind. 1457516155 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Laverne Stafford DDS are for informational purposes only.