MEDICARE: DR. BETH MORGAN MARKS D.D.S.

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	122300000X	Dentist	12009534	IN

General Provider Information

NPI Number	:	1609186444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BETH MORGAN MARKS D.D.S.

Provider Business Mailing Address
First Line	:	6221 COVINGTON RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-7311
Country	:	US
Telephone Number	:	260-432-4329
Fax Number	:	260-434-1570

Provider Business Practice Location Address
First Line	:	6221 COVINGTON RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-7311
Country	:	US
Telephone Number	:	260-432-4329
Fax Number	:	260-434-1570

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

Provider Enumeration Date	:	10/14/2010
Last Update Date	:	12/04/2025

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