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Individual

LAWRENCE E MARABLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
3661 EISENHOWER PKWY, SUITE # 268, MACON, GA 31206-3649
(478) 474-8037
(478) 474-8367
Mailing address
3661 EISENHOWER PKWY, SUITE # 268, MACON, GA 31206-3649
(478) 474-8037
(478) 474-8367

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10227
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00302772B
GA
05
00302772C
GA
Enumeration date
06/21/2006
Last updated
12/19/2013
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