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NPI Code Detail

MEDICARE: PERRY LEE MARCEL D.D.S.

MEDICARE: PERRY LEE MARCEL D.D.S.
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
1122300000XDentist17823TX

General Provider Information

NPI Number : 1548342025
Entity Type Code : Individual
Provider Name (Legal Business Name) : PERRY LEE MARCEL D.D.S.
Provider Business Mailing Address
First Line : 7120 CARMONA
Second Line :
City : GRAND PRAIRIE
State : TX
Zip : 75054-6799
Country : US
Telephone Number : 817-771-7149
Fax Number :
Provider Business Practice Location Address
First Line : 7120 CARMONA
Second Line :
City : GRAND PRAIRIE
State : TX
Zip : 75054-6799
Country : US
Telephone Number : 817-771-7149
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 01/28/2021

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