Organization
MARK L GROSKO DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK L GROSKO DDS (PRESIDENT)
(740) 344-6349
Entity
Organization
Contact information
Practice address
843 N 21ST ST, SUITE 103, NEWARK, OH 43055-7273
(740) 344-6349
(740) 344-6350
Mailing address
843 N 21ST ST, SUITE 103, NEWARK, OH 43055-7273
(740) 344-6349
(740) 344-6350
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
OH21555
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1400162
UNITED CONCORDIA
OH
01
—
187028
COMPBENEFITS FACILITY #
OH
01
—
195423983004
MEDICAL MUTUAL
OH
05
—
2424693
—
OH
01
—
256022
CIGNA
OH
01
—
440265
SUPERIOR
OH
01
—
9185647
DORAL PROVIDER ID
OH
Enumeration date
01/26/2007
Last updated
09/27/2011
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