Mashburn, Mark L

Mashburn, Mark L is an individual health care provider with primary practice located at 1400 College Dr Ste 204 , Texarkana TX 75503-3575. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / General Practice is his primary health care specialty. Mashburn, Mark L can be contacted via phone (903) 791-1110.

Contact Information

Primary practice address
1400 College Dr Ste 204 Texarkana TX 75503-3575
Phone: (903) 791-1110
Fax: (903) 791-9353
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 22854 Texas
Dental Providers / General Practice 1223G0001X 3526 Arkansas
Dental Providers / General Practice 1223G0001X 22854 Texas

Profile Details

NPI number 1417035395
LBN Legal business name Mashburn, Mark L
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Aug 28th, 2023 - about last year

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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Identifiers

StateTypeNumberIssuer
All States NPI 1417035395 NPPES
Texas Other 22854 TX LICENSE
Texas Other 1746328 TX LICENSE
Texas Other 5Y565 TX LICENSE

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