Provider Demographics
NPI:1033366083
Name:MARK A DREHER DDS MD PC
Entity Type:Organization
Organization Name:MARK A DREHER DDS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL SURGEON
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:DREHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MD
Authorized Official - Phone:607-798-7169
Mailing Address - Street 1:161 RIVERSIDE DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-4176
Mailing Address - Country:US
Mailing Address - Phone:607-748-7169
Mailing Address - Fax:607-798-9204
Practice Address - Street 1:161 RIVERSIDE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-4176
Practice Address - Country:US
Practice Address - Phone:607-748-7169
Practice Address - Fax:607-798-9204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053532122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty