Provider Demographics
NPI:1083737407
Name:WINKLER, MARK MORELL (DDS, MS,PHD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:MORELL
Last Name:WINKLER
Suffix:
Gender:M
Credentials:DDS, MS,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 BENNETT DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70435-9436
Mailing Address - Country:US
Mailing Address - Phone:985-875-0336
Mailing Address - Fax:
Practice Address - Street 1:1100 FLORIDA AVE
Practice Address - Street 2:DEPT. OF COMPREHENSIVE DENTISTRY
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-2714
Practice Address - Country:US
Practice Address - Phone:504-941-8269
Practice Address - Fax:504-941-8218
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA36081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice