Ciovacco, Mark George

Ciovacco, Mark George is an individual health care provider with primary practice located at 35 Lagrange Ave , Poughkeepsie NY 12603-2410. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Ciovacco, Mark George can be contacted via phone (845) 471-4350.

Contact Information

Primary practice address
35 Lagrange Ave Poughkeepsie NY 12603-2410
Phone: (845) 471-4350
Fax: (845) 471-3955
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 034089 New York

Profile Details

NPI number 1306973177
LBN Legal business name Ciovacco, Mark George
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306973177 NPPES
New York MEDICAID 00569936

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