Lange, Mark Albert
Lange, Mark Albert is an individual health care provider with primary practice located at 2320 Glade St , Muskegon MI 49444-1317. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Lange, Mark Albert can be contacted via phone (231) 733-7708.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 012522 | Michigan |
Profile Details
| NPI number | 1467517607 |
|---|---|
| LBN Legal business name | Lange, Mark Albert |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 27th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 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 | 1467517607 | NPPES |
| Michigan | MEDICAID | 4054547 |
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