Provider Demographics
NPI:1154133759
Name:W. MARK SIVLEY DDS PLLC
Entity type:Organization
Organization Name:W. MARK SIVLEY DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:SIVLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:325-692-1580
Mailing Address - Street 1:4373 TREANOR DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-7065
Mailing Address - Country:US
Mailing Address - Phone:325-692-1580
Mailing Address - Fax:325-692-4865
Practice Address - Street 1:4373 TREANOR DR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-7065
Practice Address - Country:US
Practice Address - Phone:325-692-1580
Practice Address - Fax:325-692-4865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty