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General NPI Number Information
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NPI Number | 1114030053
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Entity Type | Individual
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Provider Name | MARK ELWIN SOWARDS D.D.S.,M.S.
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Gender | Male
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1030 W 24TH ST STE C-1
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City | YUMA
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State | AZ
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Zip | 85364-8319
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Country | US
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Telephone | 928-343-9559
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Fax | 928-343-0084
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Provider Business Mailing Address
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Address Line | 1244 S 41ST DR
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City | YUMA
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State | AZ
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Zip | 85364-4075
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Country | US
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Telephone | 928-446-3581
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State | AZ
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