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NPI Code Detail

MEDICARE: DR. MARK F SOMMER DDS

MEDICARE: DR. MARK F SOMMER 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
11223G0001XGeneral Practice Dentistry36694NY

General Provider Information

NPI Number : 1649279084
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK F SOMMER DDS
Provider Business Mailing Address
First Line : 9 BENDER CT
Second Line :
City : DIX HILLS
State : NY
Zip : 11746-6100
Country : US
Telephone Number : 631-274-9244
Fax Number : 631-274-9243
Provider Business Practice Location Address
First Line : 2001 MARCUS AVE
Second Line : SUITE W82
City : LAKE SUCCESS
State : NY
Zip : 11042-1011
Country : US
Telephone Number : 516-328-1144
Fax Number : 516-328-1147
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 07/08/2007

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