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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MARK WIATT, DDS

Active

MARK WIATT, DDS is a Dentist healthcare provider located in T OR C, New Mexico. NPI 1801889209 is currently active in the NPPES registry. Verify at CMS.

Dentist · T OR C, NM

Registration Details

NPI Number
1801889209
Provider Type
Individual
Gender
Male
NPI Issued
Aug 31, 2005 (20.779040592408 yrs)
Last Updated
Dec 18, 2007
License
DD-2602 (NM)

Practice Information

Address
1960 N DATE ST
T OR C, NM, 879013701
Browse NM providers · Browse ZIP 87901
Phone
5052673088
Fax
5052671747
Primary Specialty
Dentist
122300000X

Other Dentist Providers in T OR C, NM

Name Credential NPI
LEROY BACA DDS 1154314177
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.