Provider Demographics
NPI:1164572343
Name:MCFARLAND, MARK A (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:MCFARLAND
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4349 GEX RD.
Mailing Address - Street 2:SUITE A
Mailing Address - City:DIAMONDHEAD
Mailing Address - State:MS
Mailing Address - Zip Code:39525-3235
Mailing Address - Country:US
Mailing Address - Phone:228-255-6657
Mailing Address - Fax:228-255-6038
Practice Address - Street 1:4349 GEX RD.
Practice Address - Street 2:SUITE A
Practice Address - City:DIAMONDHEAD
Practice Address - State:MS
Practice Address - Zip Code:39525-3235
Practice Address - Country:US
Practice Address - Phone:228-255-6657
Practice Address - Fax:228-255-6038
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2684-92D122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist