Provider Demographics
NPI:1003841586
Name:UGAI, MARK F (DDS)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:F
Last Name:UGAI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 E 2ND AVE
Mailing Address - Street 2:SUITE 270
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-5475
Mailing Address - Country:US
Mailing Address - Phone:970-247-4848
Mailing Address - Fax:
Practice Address - Street 1:835 E 2ND AVE
Practice Address - Street 2:SUITE 270
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5475
Practice Address - Country:US
Practice Address - Phone:970-247-4848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COH-D-1-053911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice