Provider Demographics
NPI:1790852457
Name:SEDLAK, MARK FRANK (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:FRANK
Last Name:SEDLAK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2021A CUNNINGHAM DR
Mailing Address - Street 2:SUITE #6
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-3320
Mailing Address - Country:US
Mailing Address - Phone:757-827-0580
Mailing Address - Fax:757-838-6893
Practice Address - Street 1:2021A CUNNINGHAM DR
Practice Address - Street 2:SUITE #6
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3320
Practice Address - Country:US
Practice Address - Phone:757-827-0580
Practice Address - Fax:757-838-6893
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA04010066051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice