Provider Demographics
NPI:1811020316
Name:MARKLE, LINDA (DMD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:MARKLE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ROAD 3773
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-3205
Mailing Address - Country:US
Mailing Address - Phone:406-653-1641
Mailing Address - Fax:405-653-3728
Practice Address - Street 1:3501 N BUTLER AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-6429
Practice Address - Country:US
Practice Address - Phone:505-564-4470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD5709122300000X
KY7072122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ556201Medicaid