MEDICARE: MARCIA L. REMENTER, DMD, PA

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	5456	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972832723
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARCIA L. REMENTER, DMD, PA

Provider Business Mailing Address
First Line	:	3811 N ROXBORO ST
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27704-5800
Country	:	US
Telephone Number	:	919-477-3369
Fax Number	:

Provider Business Practice Location Address
First Line	:	3811 N ROXBORO ST
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27704-5800
Country	:	US
Telephone Number	:	919-477-3369
Fax Number	:	919-479-1610

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARCIA L REMENTER
Credential	:	DMD
Telephone Number	:	919-477-3369

Provider Enumeration Date	:	12/08/2009
Last Update Date	:	12/08/2009

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