MEDICARE: DR. LAWRENCE HAROLD MARKS D.M.D.

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	1223P0700X	Prosthodontics	DN0011837	FL

General Provider Information

NPI Number	:	1316956469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE HAROLD MARKS D.M.D.

Provider Business Mailing Address
First Line	:	3340 N 37TH ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-2518
Country	:	US
Telephone Number	:	954-981-9271
Fax Number	:

Provider Business Practice Location Address
First Line	:	1825 NE 45TH ST
Second Line	:	SUITE C
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-5117
Country	:	US
Telephone Number	:	954-776-9025
Fax Number	:	954-772-4980

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

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	08/19/2009

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