MEDICARE: DR. MARKUS KOSTER 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	3338	NV

General Provider Information

NPI Number	:	1386862985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARKUS KOSTER DDS

Provider Business Mailing Address
First Line	:	PO BOX 570115
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89157-0115
Country	:	US
Telephone Number	:	702-645-3366
Fax Number	:	702-645-3611

Provider Business Practice Location Address
First Line	:	3222 N RANCHO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3128
Country	:	US
Telephone Number	:	702-645-3366
Fax Number	:	702-645-3611

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

Provider Enumeration Date	:	04/22/2007
Last Update Date	:	07/09/2007

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