Individual
DR. MARC CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032
(781) 883-1294
Mailing address
98 BARNES RD, STAMFORD, CT 06902-1241
(781) 883-1294
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
059069-1
NY
1223G0001X
General Practice Dentistry
11856
MA
Other
Enumeration date
03/23/2007
Last updated
06/02/2018
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