MEDICARE: ANDREW P. MARKS, DDS, PC

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	36194	NY

General Provider Information

NPI Number	:	1952584302
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDREW P. MARKS, DDS, PC

Provider Business Mailing Address
First Line	:	1525 PITKIN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-4516
Country	:	US
Telephone Number	:	718-342-3909
Fax Number	:

Provider Business Practice Location Address
First Line	:	1525 PITKIN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-4516
Country	:	US
Telephone Number	:	718-342-3909
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ANDREW PHILIP MARKS
Credential	:	DDS
Telephone Number	:	718-342-3909

Provider Enumeration Date	:	12/07/2007
Last Update Date	:	12/07/2007

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