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General NPI Number Information
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NPI Number | 1881664696
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Entity Type | Individual
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Provider Name | VICTOR M. MOK DMD
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Gender | Male
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 10/17/2018
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Provider Practice Location Address
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Address Line | HIGHWAY 264, MP 388
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City | POLACCA
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State | AZ
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Zip | 86042
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Country | US
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Telephone | 928-737-6000
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Fax | 505-722-1565
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Provider Business Mailing Address
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Address Line | P.O. BOX 4000
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City | POLACCA
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State | AZ
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Zip | 86042
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Country | US
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Telephone | 928-737-6085
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Fax | 505-722-1310
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DS036637
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License Number State | PA
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