Provider Demographics
NPI:1841586948
Name:DR. T. MARK ANTHONY D.D.S. P.A.
Entity Type:Organization
Organization Name:DR. T. MARK ANTHONY D.D.S. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:ANTHONY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-262-3100
Mailing Address - Street 1:2840 MALVERN AVE
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-8320
Mailing Address - Country:US
Mailing Address - Phone:501-262-3100
Mailing Address - Fax:501-881-4259
Practice Address - Street 1:2840 MALVERN AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-8320
Practice Address - Country:US
Practice Address - Phone:501-262-3100
Practice Address - Fax:501-881-4259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2105261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental