Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 058404-1 | NY |
N | 1223P0221X | Pediatric Dentist | DN1855943 | MA |
NPI | 1013277037 |
---|---|
Provider Name | Dr. Mark M. Dawoud |
First Address | Nanuet, NY 10954-5904 |
Second Address | Middletown, NY 10940-6501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2012 |
Last Update Date | 17/03/2018 |