Wingate, Mark Wade

Wingate, Mark Wade is an individual health care provider with primary practice located at 5001 Lakewood Drive , Waco TX 76710-2920. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Wingate, Mark Wade can be contacted via phone (254) 772-0180.

Contact Information

Primary practice address
5001 Lakewood Drive Waco TX 76710-2920
Fax: (254) 772-0181
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 16407 Texas

Profile Details

NPI number 1992854376
LBN Legal business name Wingate, Mark Wade
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
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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Identifiers

StateTypeNumberIssuer
All States NPI 1992854376 NPPES
Texas Other BCBSD16407 BCBS

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