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General NPI Number Information
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NPI Number | 1891922092
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Entity Type | Individual
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Provider Name | MARK G KARPOVCK DMD
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Gender | Male
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Dates
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Enumeration Date | 06/15/2009
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Last Update Date | 10/21/2011
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Provider Practice Location Address
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Address Line | 101 S US HIGHWAY 441
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City | LADY LAKE
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State | FL
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Zip | 32159-4378
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Country | US
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Telephone | 352-753-1114
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Fax | 352-753-9127
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Provider Business Mailing Address
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Address Line | 101 S US HIGHWAY 441
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City | LADY LAKE
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State | FL
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Zip | 32159-4378
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Country | US
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Telephone | 352-753-1114
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Fax | 352-753-9127
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN12163
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License Number State | FL
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