Mark A.herzog

NPI #1487992004 in Ellsworth, Kansas

Provider Information

NPI Number: 1487992004
Entity Type: Organization
Organization Name: Mark A.herzog
Primary Specialty: Dentist
Enumeration Date: Jan 17, 2013
Last Updated: Jan 17, 2013

Practice Location

Address: 804 E 8TH ST
City: Ellsworth
State: Kansas
ZIP Code: 67439-2535
Phone: (785) 472-5420

Authorized Official

Name: DR. MARK ALAN HERZOG, D.D.S.
Title: PRESIDENT
Phone: (785) 472-5420

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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