Provider Demographics
NPI:1902631492
Name:MARK LEVY DDS INC
Entity type:Organization
Organization Name:MARK LEVY DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-777-7350
Mailing Address - Street 1:1335 DUBLIN RD STE 100B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-1000
Mailing Address - Country:US
Mailing Address - Phone:614-777-7350
Mailing Address - Fax:888-390-0424
Practice Address - Street 1:415 COLEMANS XING
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-7068
Practice Address - Country:US
Practice Address - Phone:614-777-7350
Practice Address - Fax:888-390-0424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty