Provider Demographics
NPI:1073590238
Name:PREECE, MARK H (DDS)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:H
Last Name:PREECE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 WALKER ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-2518
Mailing Address - Country:US
Mailing Address - Phone:401-723-1750
Mailing Address - Fax:401-726-8660
Practice Address - Street 1:95 WALKER ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-2518
Practice Address - Country:US
Practice Address - Phone:401-723-1750
Practice Address - Fax:401-726-8660
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI22341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice