Mark Lance Ethridge, D.D.S.

Dentist · Richardson, TX

Individual Active NPI

NPI number 1164513685

Practice location

1101 N Jupiter Rd
Suite 109
Richardson, TX 75081-3171
Phone
(972) 669-9060
Fax
(972) 669-4108

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NPI record

NPI
1164513685
Entity type
Individual (Type 1)
Enumeration date
September 28, 2006
Last updated
July 8, 2007
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 18958 TX

About Dr. Ethridge

Mark Lance Ethridge, D.D.S. is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 1101 N Jupiter Rd, Suite 109, Richardson, TX 75081-3171. The NPI number 1164513685 was assigned on September 28, 2006 and the record was last updated on July 8, 2007.

Dr. Ethridge lists a license in the registry: #18958 (TX) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Mark Lance Ethridge, D.D.S.?

The NPI number is 1164513685.

What is the phone number of Dr. Ethridge?

The phone number listed for the practice location is (972) 669-9060.

Where is Dr. Ethridge located?

1101 N Jupiter Rd, Suite 109, Richardson, TX 75081-3171.

What is the taxonomy code for Dr. Ethridge?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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