Provider Demographics
NPI:1326160581
Name:ENDODONTICS SOUTH, INC.
Entity Type:Organization
Organization Name:ENDODONTICS SOUTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:DINKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PHD
Authorized Official - Phone:937-291-0022
Mailing Address - Street 1:7501 PARAGON RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-5318
Mailing Address - Country:US
Mailing Address - Phone:937-291-0022
Mailing Address - Fax:937-291-0190
Practice Address - Street 1:7501 PARAGON RD
Practice Address - Street 2:SUITE 203
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-5318
Practice Address - Country:US
Practice Address - Phone:937-291-0022
Practice Address - Fax:937-291-0190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300197251223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty