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General NPI Number Information
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NPI Number | 1134530728
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Entity Type | Organization
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Legal Business Name | MARKET STREET DENTAL, P.C.
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Dates
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Enumeration Date | 05/16/2014
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Last Update Date | 05/16/2014
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Provider Practice Location Address
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Address Line | 1820 E MARKET ST
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City | YORK
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State | PA
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Zip | 17402-2835
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Country | US
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Telephone | 717-757-3851
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Fax |
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Provider Business Mailing Address
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Address Line | 1820 E MARKET ST
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City | YORK
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State | PA
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Zip | 17402-2835
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Country | US
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Telephone | 717-757-3851
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JACQUELINE MARCIN
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Credential |
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Telephone | 717-757-3851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS025765L
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License Number State | PA
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