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General NPI Number Information
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NPI Number | 1073658266
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Entity Type | Organization
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Legal Business Name | MARK C SANTAMARIA DDS PC
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 838 SOUTH MAIN ST
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City | PLYMOUTH
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State | MI
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Zip | 48170-2047
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Country | US
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Telephone | 734-459-2400
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Fax | 734-459-9463
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Provider Business Mailing Address
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Address Line | 838 SOUTH MAIN ST
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City | PLYMOUTH
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State | MI
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Zip | 48170-2047
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Country | US
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Telephone | 734-459-2400
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Fax | 734-459-9463
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK CHRISTOPHER SANTAMARIA
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Credential | DDS
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Telephone | 734-459-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901012880
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License Number State | MI
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