DR. Mark L Cannon, DDS, MS
NPI #1891731121 in Long Grove, Illinois
Provider Information
- NPI Number
- 1891731121
- Entity Type
- Individual
- Name
- DR. Mark L Cannon, DDS, MS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - Pediatric Dentistry
- Credential
- DDS, MS
- Enumeration Date
- Jun 22, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 4160 RFD
- Address 2
- GROVE MEDICAL CENTER, SUITE 308
- City
- Long Grove
- State
- Illinois
- ZIP Code
- 60047-9583
- Phone
- (847) 634-6166
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
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