Provider Demographics
NPI:1285740241
Name:MARK J. DANNER, DMD, LLC
Entity type:Organization
Organization Name:MARK J. DANNER, DMD, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:DANNER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:856-589-7700
Mailing Address - Street 1:539 EGG HARBOR RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2371
Mailing Address - Country:US
Mailing Address - Phone:856-589-7700
Mailing Address - Fax:
Practice Address - Street 1:539 EGG HARBOR RD
Practice Address - Street 2:SUITE 4
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2371
Practice Address - Country:US
Practice Address - Phone:856-589-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty