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NPI Code Detail

MEDICARE: MARK LESTER MCCLENDON D.D.S.

MEDICARE:   MARK LESTER MCCLENDON  D.D.S.
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
11223G0001XGeneral Practice DentistryDN0011846FL

General Provider Information

NPI Number : 1922094176
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK LESTER MCCLENDON D.D.S.
Provider Business Mailing Address
First Line : 1020 N MILLS AVE
Second Line :
City : ARCADIA
State : FL
Zip : 34266-8811
Country : US
Telephone Number : 863-494-6116
Fax Number : 863-494-2660
Provider Business Practice Location Address
First Line : 1020 N MILLS AVE
Second Line :
City : ARCADIA
State : FL
Zip : 34266-8811
Country : US
Telephone Number : 863-494-6116
Fax Number : 863-494-2660
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2005
Last Update Date : 07/08/2007

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Directions to “ MARK LESTER MCCLENDON D.D.S.” Practice Location

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