Provider Demographics
NPI:1669506242
Name:DRINCIC, MARKO (DDS)
Entity Type:Individual
Prefix:
First Name:MARKO
Middle Name:
Last Name:DRINCIC
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:PO BOX 790
Mailing Address - Street 2:650 ZEDIKER AVE.
Mailing Address - City:PARLIER
Mailing Address - State:CA
Mailing Address - Zip Code:93648-0790
Mailing Address - Country:US
Mailing Address - Phone:559-646-6618
Mailing Address - Fax:559-646-6614
Practice Address - Street 1:650 S ZEDIKER AVE
Practice Address - Street 2:
Practice Address - City:PARLIER
Practice Address - State:CA
Practice Address - Zip Code:93648-2639
Practice Address - Country:US
Practice Address - Phone:559-646-6618
Practice Address - Fax:559-646-6614
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA448661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA44866OtherCALIFORNIA DENTAL LIC#