Provider Demographics
NPI:1508996075
Name:TRUMAN, MARK (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:TRUMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:851 S RAMPART BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-4882
Mailing Address - Country:US
Mailing Address - Phone:702-360-9000
Mailing Address - Fax:702-320-9045
Practice Address - Street 1:851 S RAMPART BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-4882
Practice Address - Country:US
Practice Address - Phone:702-360-9000
Practice Address - Fax:702-320-9045
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV4080-S3-691223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics