Provider Demographics
NPI:1497813182
Name:EVESBORO DENTAL ASSOCIATES PA
Entity Type:Organization
Organization Name:EVESBORO DENTAL ASSOCIATES PA
Other - Org Name:DR MARK PINTER EVESBORO DENTAL ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:PINTER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:856-985-0330
Mailing Address - Street 1:105B EVESBORO MEDFORD ROAD
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3865
Mailing Address - Country:US
Mailing Address - Phone:856-985-0330
Mailing Address - Fax:856-988-7283
Practice Address - Street 1:105B EVESBORO MEDFORD ROAD
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3865
Practice Address - Country:US
Practice Address - Phone:856-985-0330
Practice Address - Fax:856-988-7283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty