Mark David Dlugokinski, DDS
Individual provider Active NPI General Practice Dentistry · Blue Ridge, GA
NPI 1295852499 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1295852499
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DN011943 (GA)
- Practice address
- 101 Riverstone Vista
Ste 202
Blue Ridge, GA 30513 - Phone
- (706) 258-4166
- Fax
- (706) 258-4167
- NPI assigned
- Mar 23, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN011943 | GA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN011943 | GA | Yes |
Addresses
Primary practice location
101 Riverstone Vista
Ste 202
Blue Ridge, GA 30513
Mailing address
101 Riverstone Vista
Ste 202
Blue Ridge, GA 30513
Phone (706) 258-4166
Other providers in Blue Ridge, GA
- Dean D. Worthingstun, DO, PC
- Magalie Dean
- Maggie Elizabeth Dean
- Larry Dale Deyton
- Sarah Grace Dills
- Ashley Dockery
- Charles Nolan Dooley Sr.
- Tammy Dorsey
- Samantha Dougherty
- Charles Wessinger Duke
All providers in Blue Ridge, GA · General Practice Dentistry in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.