| R Mark Owens Dmd Pa | |
|
642 S Pearson Road Pearl MS 39208 | |
| (601) 939-2377 | |
| (601) 939-2529 |
| Full Name | R Mark Owens Dmd Pa |
|---|---|
| Speciality | Dentist |
| Location | 642 S Pearson Road, Pearl, Mississippi |
| Authorized Official Name and Position | Robert Mark Owens (OWNER) |
| Authorized Official Contact | 6019392377 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| R Mark Owens Dmd Pa 642 S Pearson Road Pearl MS 39208 Ph: (601) 939-2377 | R Mark Owens Dmd Pa 642 S Pearson Road Pearl MS 39208 Ph: (601) 939-2377 |
| NPI Number | 1255415220 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 05/27/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255415220 | NPI | - | NPPES |
| 03650331 | Medicaid | MS | |
| 425491211 | Other | MS | BCBS OF MS |
| 902980 | Other | MS | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 301197 (Mississippi) | Primary |
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