DR. Mark B. Tickle, DMD

NPI #1477886026 in Prattville, Alabama

Provider Information

NPI Number: 1477886026
Entity Type: Individual
Name: DR. Mark B. Tickle, DMD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Sep 15, 2009
Last Updated: Sep 15, 2009

Practice Location

Address: 711 KORNEGAY DR
Address 2: SUITE A
City: Prattville
State: Alabama
ZIP Code: 36066-7715
Phone: (334) 285-7111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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