MEDICARE: DEMARCO DENTAL, PLLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1801504352
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEMARCO DENTAL, PLLC

Provider Business Mailing Address
First Line	:	331 SPORTSPLEX DR
Second Line	:
City	:	DRIPPING SPRINGS
State	:	TX
Zip	:	78620-5349
Country	:	US
Telephone Number	:	512-858-7200
Fax Number	:

Provider Business Practice Location Address
First Line	:	331 SPORTSPLEX DR
Second Line	:
City	:	DRIPPING SPRINGS
State	:	TX
Zip	:	78620-5349
Country	:	US
Telephone Number	:	512-858-7200
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHRISTOPHER FRANCIS DEMARCO
Credential	:	DDS
Telephone Number	:	404-353-2979

Provider Enumeration Date	:	11/14/2022
Last Update Date	:	11/14/2022

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