Provider Demographics
NPI:1346490331
Name:TRANBY, MARK (DMD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:TRANBY
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 1:3950 GOODPASTURE LOOP
Mailing Address - Street 2:O-341
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-1578
Mailing Address - Country:US
Mailing Address - Phone:503-860-7285
Mailing Address - Fax:
Practice Address - Street 1:227 Q ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-2169
Practice Address - Country:US
Practice Address - Phone:541-726-9300
Practice Address - Fax:541-726-9449
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD9188122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist