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NPI Code Detail

MEDICARE: DR. MARC CHARLES PLAISANCE JR. DMD

MEDICARE:  DR. MARC CHARLES PLAISANCE JR. DMD
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
11223G0001XGeneral Practice DentistryDN015661GA

General Provider Information

NPI Number : 1720583487
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARC CHARLES PLAISANCE JR. DMD
Provider Business Mailing Address
First Line : 6369 CHERRY TREE LN
Second Line :
City : ATLANTA
State : GA
Zip : 30328-3314
Country : US
Telephone Number : 678-232-9573
Fax Number :
Provider Business Practice Location Address
First Line : 2751 BUFORD HWY NE STE 302
Second Line :
City : ATLANTA
State : GA
Zip : 30324-5456
Country : US
Telephone Number : 404-634-1277
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2018
Last Update Date : 06/29/2020

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Directions to “ DR. MARC CHARLES PLAISANCE JR. DMD” Practice Location

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