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NPI Code Detail

MEDICARE: DR. MARK MIDHAT HABIB DDS

MEDICARE: DR. MARK MIDHAT HABIB 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
1122300000XDentistDEN.00205230CO
21223G0001XGeneral Practice DentistryDEN.00205230CO

General Provider Information

NPI Number : 1518699800
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK MIDHAT HABIB DDS
Provider Business Mailing Address
First Line : 1667 COCHRANE CIR BLDG 7495
Second Line :
City : FORT CARSON
State : CO
Zip : 80913-4603
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1650 COCHRANE CIR
Second Line :
City : FORT CARSON
State : CO
Zip : 80913-4613
Country : US
Telephone Number : 719-339-6601
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2022
Last Update Date : 06/09/2026

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