Provider Demographics
NPI:1013031038
Name:GORBY, MARK B (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:B
Last Name:GORBY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14731 N. CLEVELAND AVE.
Mailing Address - Street 2:SUITE 1 COMMUNITY DENTAL CARE
Mailing Address - City:N. FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903
Mailing Address - Country:US
Mailing Address - Phone:239-995-2257
Mailing Address - Fax:239-995-4388
Practice Address - Street 1:14731 N. CLEVELAND AVE.
Practice Address - Street 2:SUITE 1 COMMUNITY DENTAL CARE
Practice Address - City:N. FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903
Practice Address - Country:US
Practice Address - Phone:239-995-2257
Practice Address - Fax:239-995-4388
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 92141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice