MEDICARE: TROY MARBURGER 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	1223G0001X	General Practice Dentistry	16207	TX

General Provider Information

NPI Number	:	1699732933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TROY MARBURGER DDS

Provider Business Mailing Address
First Line	:	1060 GAFFNEY ROAD #7500
Second Line	:	USA DENTAL ACTIVITY-ALASKA
City	:	FORT WAINWRIGHT
State	:	AK
Zip	:	99703
Country	:	US
Telephone Number	:	907-361-5530
Fax Number	:

Provider Business Practice Location Address
First Line	:	1060 GAFFNEY ROAD #7500
Second Line	:	USA DENTAL ACTIVITY-ALASKA
City	:	FORT WAINWRIGHT
State	:	AK
Zip	:	99703
Country	:	US
Telephone Number	:	907-361-5530
Fax Number	:

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

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	09/18/2009

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