| Dr. Mark Pothitakis | |
|
107 E Toothache Dr New London IA 52645-1141 | |
| (319) 367-2311 | |
| Not Available |
| Full Name | Dr. Mark Pothitakis |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 107 E Toothache Dr, New London, Iowa |
| Authorized Official Name and Position | Mark Christ Pothitakis (OWNER) |
| Authorized Official Contact | 3193672311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Mark Pothitakis 107 E Toothache Dr New London IA 52645-1141 Ph: (319) 367-2311 | Dr. Mark Pothitakis 107 E Toothache Dr New London IA 52645-1141 Ph: (319) 367-2311 |
| NPI Number | 1073770467 |
|---|---|
| Provider Enumeration Date | 05/22/2008 |
| Last Update Date | 05/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073770467 | NPI | - | NPPES |
| 0086785 | Medicaid | IA | |
| 831-776 | Other | IA | PROVIDER MILITARY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7584 (Iowa) | Primary |