Provider Demographics
NPI:1386759025
Name:MARK E LEVINE DMD, PC
Entity type:Organization
Organization Name:MARK E LEVINE DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ELLIOT
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:303-695-4838
Mailing Address - Street 1:10200 E GIRARD AVE
Mailing Address - Street 2:SUITE 205; BUILDING A
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5500
Mailing Address - Country:US
Mailing Address - Phone:303-695-4838
Mailing Address - Fax:
Practice Address - Street 1:10200 E GIRARD AVE
Practice Address - Street 2:SUITE 205; BUILDING A
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-5500
Practice Address - Country:US
Practice Address - Phone:303-695-4838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1041381223E0200X, 261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
Not Answered261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental