Provider Demographics
NPI:1427498500
Name:MARION, MARK A (DMD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:MARION
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:ZELIENOPLE
Mailing Address - State:PA
Mailing Address - Zip Code:16063-1367
Mailing Address - Country:US
Mailing Address - Phone:724-452-4300
Mailing Address - Fax:724-452-3921
Practice Address - Street 1:111 S HIGH ST
Practice Address - Street 2:
Practice Address - City:ZELIENOPLE
Practice Address - State:PA
Practice Address - Zip Code:16063-1367
Practice Address - Country:US
Practice Address - Phone:724-452-4300
Practice Address - Fax:724-452-3921
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA247371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice