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
Phone: (603) 448-4200
Fax: (603) 448-6424
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649359746 | NPPES |
| New Hampshire | MEDICAID | 30300297 | |
| New Hampshire | Other | 807907 |
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