Provider Demographics
NPI:1538141056
Name:DYE, MARK NEWTON (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:NEWTON
Last Name:DYE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 W JONES ST
Mailing Address - Street 2:APT. B
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-4548
Mailing Address - Country:US
Mailing Address - Phone:912-355-2424
Mailing Address - Fax:912-356-9149
Practice Address - Street 1:310 EISENHOWER DR
Practice Address - Street 2:BUILDING 14
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2632
Practice Address - Country:US
Practice Address - Phone:912-355-2424
Practice Address - Fax:912-356-9149
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0131661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice