Provider Demographics
NPI:1932124807
Name:KALEY, MARK HAMILTON (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:HAMILTON
Last Name:KALEY
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2510 OAKCREST AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-4720
Mailing Address - Country:US
Mailing Address - Phone:336-282-2150
Mailing Address - Fax:336-282-2125
Practice Address - Street 1:2510 OAKCREST AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-4720
Practice Address - Country:US
Practice Address - Phone:336-282-2150
Practice Address - Fax:336-282-2125
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC76191223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics