Provider Demographics
NPI:1669612255
Name:MARKOSE, SONY (DDS)
Entity type:Individual
Prefix:
First Name:SONY
Middle Name:
Last Name:MARKOSE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2155 MARSH LN
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-4970
Mailing Address - Country:US
Mailing Address - Phone:973-820-8455
Mailing Address - Fax:972-695-6182
Practice Address - Street 1:2155 MARSH LN
Practice Address - Street 2:SUITE 110
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-4970
Practice Address - Country:US
Practice Address - Phone:973-820-8455
Practice Address - Fax:972-695-6182
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24531122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist