Provider Demographics
NPI:1447309703
Name:MARK N. DYE, DMD, LLC
Entity type:Organization
Organization Name:MARK N. DYE, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:NEWTON
Authorized Official - Last Name:DYE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:912-355-2424
Mailing Address - Street 1:310 EISENHOWER DR
Mailing Address - Street 2:BUILDING 14
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2632
Mailing Address - Country:US
Mailing Address - Phone:912-355-2424
Mailing Address - Fax:912-356-9149
Practice Address - Street 1:310 EISENHOWER DR
Practice Address - Street 2:BUILDING 14
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2632
Practice Address - Country:US
Practice Address - Phone:912-355-2424
Practice Address - Fax:912-356-9149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0131661223G0001X
GA71231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty