MEDICARE: DR. MARC BARRETT STERNBERG DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	14163	OH

General Provider Information

NPI Number	:	1619977717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARC BARRETT STERNBERG DDS

Provider Business Mailing Address
First Line	:	4403 STATE ROUTE 725
Second Line	:	SUITE C
City	:	BELLBROOK
State	:	OH
Zip	:	45305-2700
Country	:	US
Telephone Number	:	937-848-8662
Fax Number	:	937-848-2317

Provider Business Practice Location Address
First Line	:	4403 STATE ROUTE 725
Second Line	:	SUITE C
City	:	BELLBROOK
State	:	OH
Zip	:	45305-2700
Country	:	US
Telephone Number	:	937-848-8662
Fax Number	:	937-848-2317

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	05/28/2014

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