Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 32307 | CA |
NPI | 1073722740 |
---|---|
Provider Name | Dr. Mark Allen Garlington |
First Address | Long Beach, CA 90803-5949 |
Second Address | Long Beach, CA 90803-5949 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 08/07/2007 |