Dr. Mark Bennett Waggoner
Dentist Anesthesiologist Dentist - General Practice
3104 Harvard Ct
Plano
, Texas 75093-3450
Dr. Mark Bennett Waggoner
Dentist Anesthesiologist Dentist - General Practice
3104 Harvard Ct
Plano
, Texas 75093-3450
(972) 333-6204
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About
Features
Specialties
- Dentist Anesthesiologist
- General Practice
Languages spoken
- English
Location
First Address
- Dr. Mark Bennett Waggoner
- 3104 Harvard Ct
- Plano, TX
- Zip : 75093-3450
- Phone : (972) 333-6204
Second Address
- Dr. Mark Bennett Waggoner
- 3104 Harvard Ct
- Plano, TX
- Zip : 75093-3450
- Phone : (972) 333-6204
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 1223D0004X | Dentist Anesthesiologist | 13820 | TX |
| Y | 1223G0001X | General Practice | 13820 | TX |
| Y | 213EG0000X | General Practice | 13820 | TX |
National Provider Identifier
| NPI | 1720107717 |
|---|---|
| Provider Name | Dr. Mark Bennett Waggoner |
| First Address | Plano, TX 75093-3450 |
| Second Address | Plano, TX 75093-3450 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/03/2007 |
| Last Update Date | 23/10/2014 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.