Dr. Mark Douglas Mintline
Dentist Oral and Maxillofacial Pathology
795 E. Second St. Suite 8
Pomona
, California 91766
Dr. Mark Douglas Mintline
Dentist Oral and Maxillofacial Pathology
795 E. Second St. Suite 8
Pomona
, California 91766
(909) 469-8650
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About
Features
Specialties
- Dentist
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Dr. Mark Douglas Mintline
- 795 E. Second St. Suite 8
- Pomona, CA
- Zip : 91766-2007
- Fax : (909) 469-8650
- Phone : (909) 706-3910
Second Address
- Dr. Mark Douglas Mintline
- 795 E. Second St. Suite 8
- Pomona, CA
- Zip : 91766
- Fax : (909) 469-8650
- Phone : (909) 706-3910
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 122300000X | Dentist | 62702 | CA |
| N | 1223P0106X | Oral and Maxillofacial Pathology | 62702 | CA |
National Provider Identifier
| NPI | 1043642069 |
|---|---|
| Provider Name | Dr. Mark Douglas Mintline |
| First Address | Pomona, CA 91766-2007 |
| Second Address | Pomona, CA 91766 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/08/2013 |
| Last Update Date | 30/10/2018 |
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.