Provider Demographics
NPI:1083743025
Name:D.L. MARKHAM, DDS, MSD, INC
Entity Type:Organization
Organization Name:D.L. MARKHAM, DDS, MSD, INC
Other - Org Name:MAIDU DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:
Authorized Official - First Name:LUMINITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-823-8771
Mailing Address - Street 1:1101 MAIDU DR
Mailing Address - Street 2:#100
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-5864
Mailing Address - Country:US
Mailing Address - Phone:530-823-8771
Mailing Address - Fax:
Practice Address - Street 1:1101 MAIDU DR
Practice Address - Street 2:#100
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-5808
Practice Address - Country:US
Practice Address - Phone:530-823-8771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty