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General NPI Number Information
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NPI Number | 1043435050
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Entity Type | Individual
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Provider Name | MARK JEFFREY SCHPERO D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2200 WHITNEY AVE SUITE 250
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City | HAMDEN
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State | CT
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Zip | 06518-3691
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Country | US
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Telephone | 203-288-7273
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Fax | 203-288-2477
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Provider Business Mailing Address
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Address Line | 193 E ROCK RD
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City | NEW HAVEN
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State | CT
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Zip | 06511-1325
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Country | US
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Telephone | 203-776-5494
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 5325
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License Number State | CT
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