Provider Demographics
NPI:1932404258
Name:SONY C MARKOSE D.D.S., P.C
Entity Type:Organization
Organization Name:SONY C MARKOSE D.D.S., P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SONY
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARKOSE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:973-820-8455
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:972-695-6037
Mailing Address - Fax:
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:972-695-6037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty