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NPI Code Detail

MEDICARE: DR. JAY MARSHALL SUVERKRUP DMD, PA

MEDICARE: DR. JAY MARSHALL SUVERKRUP DMD, PA
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
11223G0001XGeneral Practice DentistryDN0008909FL

General Provider Information

NPI Number : 1144221193
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAY MARSHALL SUVERKRUP DMD, PA
Provider Business Mailing Address
First Line : 6010 N LOCKWOOD RIDGE RD
Second Line :
City : SARASOTA
State : FL
Zip : 34243-2525
Country : US
Telephone Number : 941-358-8830
Fax Number : 941-358-0442
Provider Business Practice Location Address
First Line : 6010 N LOCKWOOD RIDGE RD
Second Line :
City : SARASOTA
State : FL
Zip : 34243-2525
Country : US
Telephone Number : 941-358-8830
Fax Number : 941-358-0442
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 07/08/2007

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