DR. Mark S Thibault, DDS
NPI #1750491239 in Pinole, California
Provider Information
- NPI Number
- 1750491239
- Entity Type
- Individual
- Name
- DR. Mark S Thibault, DDS
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist - General Practice
- Credential
- DDS
- Enumeration Date
- Aug 30, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 1330 TARA HILLS DR
- Address 2
- SUITE K
- City
- Pinole
- State
- California
- ZIP Code
- 94564-2531
- Phone
- (510) 724-2074
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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