Provider Demographics
NPI:1134240500
Name:MARK V GARRITY DMD LLC
Entity type:Organization
Organization Name:MARK V GARRITY DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRITY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-477-5434
Mailing Address - Street 1:5 SUGAR PINE CIR
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-3437
Mailing Address - Country:US
Mailing Address - Phone:508-477-5434
Mailing Address - Fax:508-539-0211
Practice Address - Street 1:5 SUGAR PINE CIR
Practice Address - Street 2:
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-3437
Practice Address - Country:US
Practice Address - Phone:508-477-5434
Practice Address - Fax:508-539-0211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA194111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty