Provider Demographics
NPI:1427753342
Name:MARK R. RICE, JR., DDS, P.S.C.
Entity type:Organization
Organization Name:MARK R. RICE, JR., DDS, P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:270-393-4818
Mailing Address - Street 1:2425 SCOTTSVILLE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-4457
Mailing Address - Country:US
Mailing Address - Phone:270-393-4818
Mailing Address - Fax:
Practice Address - Street 1:2425 SCOTTSVILLE RD STE 120
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-4457
Practice Address - Country:US
Practice Address - Phone:270-393-4818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty