Provider Demographics
NPI:1700899382
Name:ROBERT E MARKS DDS PA
Entity Type:Organization
Organization Name:ROBERT E MARKS DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENIST PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:386-752-1220
Mailing Address - Street 1:389 SW CHAPEL HILL ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-6921
Mailing Address - Country:US
Mailing Address - Phone:386-752-1220
Mailing Address - Fax:
Practice Address - Street 1:389 SW CHAPEL HILL ST
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-6921
Practice Address - Country:US
Practice Address - Phone:386-752-1220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN3359122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty