MEDICARE: DR. MARK MILHEM ASHY D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN16270	FL

General Provider Information

NPI Number	:	1518998293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK MILHEM ASHY D.M.D.

Provider Business Mailing Address
First Line	:	6315 MARINA DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-4820
Country	:	US
Telephone Number	:	407-876-9892
Fax Number	:	407-658-0037

Provider Business Practice Location Address
First Line	:	13000 AVALON LAKE DR
Second Line	:	STE 201
City	:	ORLANDO
State	:	FL
Zip	:	32828-6434
Country	:	US
Telephone Number	:	407-658-0103
Fax Number	:	407-658-0037

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	07/08/2007

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