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1699919183
MARK WILLAM BANTZ
SOUTH BEND, IN
NPI
1699919183
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IN 7086)
Enumeration Date
2009-04-28
Last Update Date
2009-04-28
Business Address
Dr. MARK WILLAM BANTZ DDS
820 E COLFAX AVE
SOUTH BEND, IN 46617-2804
Phone number: 574-234-4117
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Mailing Address
Dr. MARK WILLAM BANTZ DDS
820 E COLFAX AVE
SOUTH BEND, IN 46617-2804
Phone number: 574-234-4117
Copy
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