Provider Demographics
NPI:1437245222
Name:NOCERA, MARK ALLEN (DDS)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:ALLEN
Last Name:NOCERA
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 1:6994 EL CAMINO REAL
Mailing Address - Street 2:STE. 108
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-4117
Mailing Address - Country:US
Mailing Address - Phone:760-431-7711
Mailing Address - Fax:760-431-0796
Practice Address - Street 1:6994 EL CAMINO REAL
Practice Address - Street 2:STE. 108
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-4117
Practice Address - Country:US
Practice Address - Phone:760-431-7711
Practice Address - Fax:760-431-0796
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACL385721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice