Provider Demographics
NPI:1063436608
Name:MACRI, JAMES V (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:V
Last Name:MACRI
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:51565 BITTERSWEET ROAD
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530
Mailing Address - Country:US
Mailing Address - Phone:574-277-1211
Mailing Address - Fax:574-277-5812
Practice Address - Street 1:51565 BITTERSWEET ROAD
Practice Address - Street 2:
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530
Practice Address - Country:US
Practice Address - Phone:574-277-1211
Practice Address - Fax:574-277-5812
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120071641223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics