MARK BURGESS

BLOOMINGTON, IL
NPI1154492593
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist General Practice
(Licence: IL  19020667)
Enumeration Date2006-11-09
Last Update Date2007-07-08
Business Address
DR. MARK BURGESS DMD
2103 E WASHINGTON ST STE 4B
BLOOMINGTON, IL 61701-4362
Phone number: 309-663-6564
Mailing Address
DR. MARK BURGESS DMD
2103 E WASHINGTON ST STE 4B
BLOOMINGTON, IL 61701-4362
Phone number: 309-663-6564
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