Provider Demographics
NPI:1679654628
Name:MARK M. LIMA, D.D.S.
Entity Type:Organization
Organization Name:MARK M. LIMA, D.D.S.
Other - Org Name:LONDON DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:M
Authorized Official - Last Name:LIMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:740-852-5771
Mailing Address - Street 1:116 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-1229
Mailing Address - Country:US
Mailing Address - Phone:740-852-5771
Mailing Address - Fax:740-852-6850
Practice Address - Street 1:116 E HIGH ST
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-1229
Practice Address - Country:US
Practice Address - Phone:740-852-5771
Practice Address - Fax:740-852-6850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH17376261QD0000X
OH22035261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental