Governo, Mark William

Governo, Mark William is an individual health care provider with primary practice located at 2 Campbell Street , Lebanon NH 03766. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Governo, Mark William can be contacted via phone (603) 448-4200.

Contact Information

Primary practice address
2 Campbell Street Lebanon NH 03766
Fax: (603) 448-6424
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 3123 New Hampshire

Profile Details

NPI number 1649359746
LBN Legal business name Governo, Mark William
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2006
Last updated Aug 26th, 2015 - about 11 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 1649359746 NPPES
New Hampshire MEDICAID 30300297
New Hampshire Other 807907

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