MEDICARE: MARNI VOORHEES HUSSON DDS

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	122300000X	Dentist	0401102544	VA

General Provider Information

NPI Number	:	1588945752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARNI VOORHEES HUSSON DDS

Provider Business Mailing Address
First Line	:	996 FIRST COLONIAL RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3175
Country	:	US
Telephone Number	:	757-495-3110
Fax Number	:	757-495-3110

Provider Business Practice Location Address
First Line	:	996 FIRST COLONIAL RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3175
Country	:	US
Telephone Number	:	757-495-3110
Fax Number	:	757-495-3110

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2011
Last Update Date	:	09/01/2011

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