Provider Demographics
NPI:1699732933
Name:MARBURGER, TROY (DDS)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:
Last Name:MARBURGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 GAFFNEY ROAD #7500
Mailing Address - Street 2:USA DENTAL ACTIVITY-ALASKA
Mailing Address - City:FORT WAINWRIGHT
Mailing Address - State:AK
Mailing Address - Zip Code:99703
Mailing Address - Country:US
Mailing Address - Phone:907-361-5530
Mailing Address - Fax:
Practice Address - Street 1:1060 GAFFNEY ROAD #7500
Practice Address - Street 2:USA DENTAL ACTIVITY-ALASKA
Practice Address - City:FORT WAINWRIGHT
Practice Address - State:AK
Practice Address - Zip Code:99703
Practice Address - Country:US
Practice Address - Phone:907-361-5530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX162071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice