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1144241589
MARK EDWIN FLACK
BLUE SPRINGS, MO
NPI
1144241589
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: MO 12700)
Enumeration Date
2006-07-21
Last Update Date
2007-07-09
Business Address
Dr. MARK EDWIN FLACK D.D.S.
300 NW RR MIZE RD SUITE 100
BLUE SPRINGS, MO 64014-2528
Phone number: 816-229-3737
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Mailing Address
Dr. MARK EDWIN FLACK D.D.S.
5457 NE WEDGEWOOD LN
LEES SUMMIT, MO 64064-1223
Phone number: 816-373-7968
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