Provider Demographics
NPI:1093721565
Name:MARKOVICH, SOPHIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:SOPHIE
Middle Name:
Last Name:MARKOVICH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 GIFFORD ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2912
Mailing Address - Country:US
Mailing Address - Phone:508-548-4011
Mailing Address - Fax:508-540-8800
Practice Address - Street 1:362 GIFFORD ST. UNIT B
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-0254
Practice Address - Country:US
Practice Address - Phone:508-548-4011
Practice Address - Fax:508-540-8800
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213811223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics