Provider Demographics
NPI:1629181235
Name:MCGEE, MARK EDWARD (DDS)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:EDWARD
Last Name:MCGEE
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 1:8048 MARKET ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-9384
Mailing Address - Country:US
Mailing Address - Phone:910-686-6578
Mailing Address - Fax:910-686-6512
Practice Address - Street 1:8048 MARKET ST
Practice Address - Street 2:SUITE A
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-9384
Practice Address - Country:US
Practice Address - Phone:910-686-6578
Practice Address - Fax:910-686-6512
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC57781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice