Provider Demographics
NPI:1700983699
Name:MC DADE, MARK CURTISS (DMD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:CURTISS
Last Name:MC DADE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 E DAILY DR STE 130
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-0782
Mailing Address - Country:US
Mailing Address - Phone:805-482-7615
Mailing Address - Fax:805-987-4472
Practice Address - Street 1:771 E DAILY DR STE 130
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-0782
Practice Address - Country:US
Practice Address - Phone:805-482-7615
Practice Address - Fax:805-987-4472
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA408561223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics