MEDICARE: MARK E. HARTTER, D.D.S., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	12290	MO

General Provider Information

NPI Number	:	1447457395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARK E. HARTTER, D.D.S., P.C.

Provider Business Mailing Address
First Line	:	3568 SW MARKET ST
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64082-2327
Country	:	US
Telephone Number	:	816-537-6161
Fax Number	:	816-537-6165

Provider Business Practice Location Address
First Line	:	3568 SW MARKET ST
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64082-2327
Country	:	US
Telephone Number	:	816-537-6161
Fax Number	:	816-537-6165

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARK EARL HARTTER
Credential	:	D.D.S.
Telephone Number	:	816-537-6161

Provider Enumeration Date	:	07/02/2007
Last Update Date	:	08/22/2020

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