Provider Demographics
NPI:1588945752
Name:HUSSON, MARNI VOORHEES (DDS)
Entity type:Individual
Prefix:
First Name:MARNI
Middle Name:VOORHEES
Last Name:HUSSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MARNI
Other - Middle Name:ELIZABETH
Other - Last Name:VOORHEES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:996 FIRST COLONIAL RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3175
Mailing Address - Country:US
Mailing Address - Phone:757-495-3110
Mailing Address - Fax:757-495-3110
Practice Address - Street 1:996 FIRST COLONIAL RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3175
Practice Address - Country:US
Practice Address - Phone:757-495-3110
Practice Address - Fax:757-495-3110
Is Sole Proprietor?:No
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401102544122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist