MEDICARE: DR. GUY C MARKHAM 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	122300000X	Dentist	16217	CA

General Provider Information

NPI Number	:	1861469306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GUY C MARKHAM DDS

Provider Business Mailing Address
First Line	:	922 VISTA DEL RIO
Second Line	:
City	:	SANTA MARIA
State	:	CA
Zip	:	93458
Country	:	US
Telephone Number	:	805-614-9596
Fax Number	:	805-614-9596

Provider Business Practice Location Address
First Line	:	90 VIA JUANA LANE
Second Line	:
City	:	SANTA YNEZ
State	:	CA
Zip	:	93460-9405
Country	:	US
Telephone Number	:	805-688-7070
Fax Number	:	805-686-2060

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

Provider Enumeration Date	:	03/03/2006
Last Update Date	:	07/08/2007

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