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General NPI Number Information
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NPI Number | 1356606230
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Entity Type | Individual
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Provider Name | MICHAEL S MARR II DMD
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Gender | Male
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Dates
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Enumeration Date | 07/06/2012
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Last Update Date | 02/10/2014
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Provider Practice Location Address
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Address Line | 2723 W LIBERTY ST
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City | GIRARD
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State | OH
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Zip | 44420-3158
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Country | US
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Telephone | 570-777-0301
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Fax |
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Provider Business Mailing Address
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Address Line | 4 WESNER LN
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City | DANVILLE
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State | PA
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Zip | 17821-8023
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Country | US
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Telephone | 570-275-2684
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DS039466
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License Number State | PA
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