Provider Demographics
NPI:1518025493
Name:WARING, MARK CHRISTIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:CHRISTIAN
Last Name:WARING
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 1:2080 E SOUTHERN AVE
Mailing Address - Street 2:SUITE E-102
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7599
Mailing Address - Country:US
Mailing Address - Phone:480-820-4342
Mailing Address - Fax:
Practice Address - Street 1:2080 E SOUTHERN AVE
Practice Address - Street 2:SUITE E-102
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7599
Practice Address - Country:US
Practice Address - Phone:480-820-4342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ39941223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics