Individual
DR. MARK GENCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
418 SAINT MARKS PL, STATEN ISLAND, NY 10301-2434
(718) 720-6836
(718) 720-6996
Mailing address
418 SAINT MARKS PL, STATEN ISLAND, NY 10301-2434
(718) 720-6836
(718) 720-6996
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
041072
NY
Other
Enumeration date
03/23/2016
Last updated
03/23/2016
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