MEDICARE: DR. MARK SIMEONE 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	1223G0001X	General Practice Dentistry	DS035396	PA

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	:	1346310620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK SIMEONE D.M.D.

Provider Business Mailing Address
First Line	:	401 COMMERCE DR
Second Line	:	SUITE 108
City	:	FT WASHINGTON
State	:	PA
Zip	:	19034-2714
Country	:	US
Telephone Number	:	267-464-4254
Fax Number	:	215-646-6166

Provider Business Practice Location Address
First Line	:	1500 HORIZON DR
Second Line	:	104
City	:	CHALFONT
State	:	PA
Zip	:	18914-3966
Country	:	US
Telephone Number	:	215-997-9980
Fax Number	:	215-646-6166

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

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	02/15/2013

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Directions to “ DR. MARK SIMEONE D.M.D.” Practice Location

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