Provider Demographics
NPI:1629300298
Name:MARKO KAMEL DDS PA
Entity Type:Organization
Organization Name:MARKO KAMEL DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARKO
Authorized Official - Middle Name:MICHEL
Authorized Official - Last Name:KAMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-206-6780
Mailing Address - Street 1:2112 VIKING DR NW
Mailing Address - Street 2:SUITE E
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2112 VIKING DR NW
Practice Address - Street 2:SUITE E
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-3522
Practice Address - Country:US
Practice Address - Phone:507-206-6780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARKO KAMEL DDS PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND12206302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization