| NPI | 1508261264 |
|---|---|
| Former Name | JOHN MARK AN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN00203948) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12012235A) |
| 122300000X Dentist (Licence: IL 019030490) | |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2020-08-12 |