Organization Name: | SAMARKOS, D.M.D., P.A. |
NPI Number: | 1013299338 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN A SAMARKOS (OWNER) |
Mailing Address: | 11223 N Williams St Dunnellon |
State: | FL US |
Postal Code: | 344328350 |
Phone Number: | 3524893922 |
Fax Number: | |
NPI Enumeration Date: | 09/13/2011 |
NPI Last Update Date: | 09/13/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | DN12788 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |