Organization
MARQUIS DENTAL CENTER PA
Active
Parent organization
MARQUIS DENTAL CENTER PA
Other names
Renew Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARQUIS DENTAL CENTER PA
Authorized official
DR. GEORGE JOSEPH MARQUIS D.M.D. (OWNER)
(662) 823-7900
Entity
Organization
Contact information
Practice address
1013 W JACKSON ST, TUPELO, MS 38804-1907
(662) 823-7900
(662) 823-7920
Mailing address
1013 W JACKSON ST, TUPELO, MS 38804-1907
(662) 823-7900
(662) 823-7920
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
1452-71
MS
Other
Enumeration date
10/04/2013
Last updated
10/05/2016
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