Provider Demographics
NPI:1831074269
Name:MARK R. POLLE, DDS. PLLC
Entity type:Organization
Organization Name:MARK R. POLLE, DDS. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:R
Authorized Official - Last Name:POLLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:712-253-9420
Mailing Address - Street 1:1101 LAWNDALE ST
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-1792
Mailing Address - Country:US
Mailing Address - Phone:712-253-9420
Mailing Address - Fax:
Practice Address - Street 1:2700 W. FRONTIER PARKWAY STE. 120
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078
Practice Address - Country:US
Practice Address - Phone:214-216-0843
Practice Address - Fax:214-278-6603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-06
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental