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General NPI Number Information
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NPI Number | 1528154796
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Entity Type | Individual
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Provider Name | WILLIAM JAY MARLEY JR. DDS
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Gender | Male
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4252 HOHE ST STE A
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City | HOMER
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State | AK
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Zip | 99603
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Country | US
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Telephone | 907-235-8909
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Fax | 907-235-8517
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Provider Business Mailing Address
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Address Line | 143 E BAYVIEW AVE
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City | HOMER
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State | AK
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Zip | 99603
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Country | US
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Telephone | 907-235-9649
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Fax | 907-235-9649
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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 | 1023
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License Number State | AK
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