MEDICARE: MARK W PERKO 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
1	1223G0001X	General Practice Dentistry	17277	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295889459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK W PERKO DDS

Provider Business Mailing Address
First Line	:	2045 FOREST EDGE DR
Second Line	:
City	:	CUYAHOGA FALLS
State	:	OH
Zip	:	44223-3365
Country	:	US
Telephone Number	:	330-923-3322
Fax Number	:

Provider Business Practice Location Address
First Line	:	673 E WILBETH RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44306-3455
Country	:	US
Telephone Number	:	330-724-2551
Fax Number	:	330-724-7726

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	07/08/2007

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Directions to “ MARK W PERKO DDS” Practice Location

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