Provider Demographics
NPI:1649360058
Name:EBLE, DENNIS MARK (DDS)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:MARK
Last Name:EBLE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 N MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-2707
Mailing Address - Country:US
Mailing Address - Phone:215-822-3838
Mailing Address - Fax:215-822-0751
Practice Address - Street 1:350 N MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-2707
Practice Address - Country:US
Practice Address - Phone:215-822-3838
Practice Address - Fax:215-822-0751
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028516L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA765982OtherUNITED CONCORDIA