Dake, Mark L.
Dake, Mark L. is an individual health care provider with primary practice located at 181 N Kentucky Ave , West Plains MO 65775-2089. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Dake, Mark L. can be contacted via phone (417) 256-5100.Contact Information
Primary practice address
181 N Kentucky Ave
West Plains MO 65775-2089
Phone: (417) 256-5100
Fax: (417) 257-0721
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 014271 | Missouri |
Profile Details
| NPI number | 1447260930 |
|---|---|
| LBN Legal business name | Dake, Mark L. |
| Credentials | DDS, MSD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 8th, 2006 |
| Last updated | Feb 20th, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447260930 | NPPES |
| Arkansas | MEDICAID | 113039608 | |
| Arkansas | MEDICAID | 1447260930 |
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