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Individual
MARISA MARIE HART
Active
Individual
MARISA MARIE HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901019377
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457467839
—
MI
01
—
381908328
DELTA DENTAL OF MICHIGAN
MI
01
—
D801095
BLUE CROSS BLUE SHIELD OF MICHIGAN
MN
Enumeration date
08/21/2006
Last updated
09/05/2024
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