MEDICARE: DR. TAMERAH LORRAINE MARABLE 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	1223P0221X	Pediatric Dentistry	DN015572	GA

General Provider Information

NPI Number	:	1952751695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAMERAH LORRAINE MARABLE DDS

Provider Business Mailing Address
First Line	:	2385 PEACHTREE RD NE STE A2AB
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-4139
Country	:	US
Telephone Number	:	404-750-4442
Fax Number	:

Provider Business Practice Location Address
First Line	:	2385 PEACHTREE RD NE STE A2AB
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-4139
Country	:	US
Telephone Number	:	404-750-4442
Fax Number	:

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

Provider Enumeration Date	:	06/14/2016
Last Update Date	:	02/04/2025

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