Provider Demographics
NPI:1013047687
Name:DR MARK A STEELE DDS PA
Entity Type:Organization
Organization Name:DR MARK A STEELE DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:352-787-3789
Mailing Address - Street 1:607 W DIXIE AVE
Mailing Address - Street 2:DR MARK A STEELE
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-6356
Mailing Address - Country:US
Mailing Address - Phone:352-787-3789
Mailing Address - Fax:
Practice Address - Street 1:607 W DIXIE AVE
Practice Address - Street 2:DR MARK A STEELE
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-6356
Practice Address - Country:US
Practice Address - Phone:352-787-3789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00122461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty