MEDICARE: DR. MARK S. SCURRIA DDS

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	1223P0700X	Prosthodontics	5845	NC

General Provider Information

NPI Number	:	1700888062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK S. SCURRIA DDS

Provider Business Mailing Address
First Line	:	1920 E CHAPEL HILL NELSON HWY
Second Line	:	STE 410
City	:	DURHAM
State	:	NC
Zip	:	27713-2262
Country	:	US
Telephone Number	:	919-544-8106
Fax Number	:	919-544-8536

Provider Business Practice Location Address
First Line	:	1920 E CHAPEL HILL NELSON HWY
Second Line	:	STE 410
City	:	DURHAM
State	:	NC
Zip	:	27713-2262
Country	:	US
Telephone Number	:	919-544-8106
Fax Number	:	919-544-8536

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	07/08/2007

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