Cannon, Mark L

Cannon, Mark L is an individual health care provider with primary practice located at 4160 Rfd Grove Medical Center, Suite 308, Long Grove IL 60047-9583. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Cannon, Mark L can be contacted via phone (847) 634-6166.

Contact Information

Primary practice address
4160 Rfd Grove Medical Center, Suite 308 Long Grove IL 60047-9583
Phone: (847) 634-6166
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X Illinois

Profile Details

NPI number 1891731121
LBN Legal business name Cannon, Mark L
Credentials DDS, MS
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Jul 8th, 2007 - about 17 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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