Provider Demographics
NPI:1205497880
Name:MARK E GLEIXNER, DDS, PC
Entity type:Organization
Organization Name:MARK E GLEIXNER, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:GLEIXNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-885-7760
Mailing Address - Street 1:1678 FRY RD STE B
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-1176
Mailing Address - Country:US
Mailing Address - Phone:317-885-7760
Mailing Address - Fax:317-885-7813
Practice Address - Street 1:1678 FRY RD STE B
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-1176
Practice Address - Country:US
Practice Address - Phone:317-885-7760
Practice Address - Fax:317-885-7813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental