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NPI Code Detail

MEDICARE: MR. VINCENT D MARKOVITZ DDS

MEDICARE: MR. VINCENT D MARKOVITZ 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
11223D0001XPublic Health Dentistry00204734CO

General Provider Information

NPI Number : 1124694898
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VINCENT D MARKOVITZ DDS
Provider Business Mailing Address
First Line : 808 EDGEWOOD AVE
Second Line :
City : COLUMBIA
State : MO
Zip : 65203-2821
Country : US
Telephone Number : 573-424-1089
Fax Number :
Provider Business Practice Location Address
First Line : 1815 JET WING DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80916-2300
Country : US
Telephone Number : 719-632-5700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2021
Last Update Date : 07/03/2023

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