Provider Demographics
NPI:1699029983
Name:TRAUGH, MARK STEVEN (DDS)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:STEVEN
Last Name:TRAUGH
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 1:5689 ROSECLIFF DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-8831
Mailing Address - Country:US
Mailing Address - Phone:614-579-0323
Mailing Address - Fax:
Practice Address - Street 1:5993 HOME RD
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-9478
Practice Address - Country:US
Practice Address - Phone:740-881-3559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30017432122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist