Provider Demographics
NPI:1699901579
Name:MAREK, TERI LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:TERI
Middle Name:LYNN
Last Name:MAREK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WHITFIELD ST
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-5281
Mailing Address - Country:US
Mailing Address - Phone:512-846-1372
Mailing Address - Fax:
Practice Address - Street 1:123 ED SCHMIDT BLVD STE 100
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-5586
Practice Address - Country:US
Practice Address - Phone:512-846-2646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24661122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist