Provider Demographics
NPI:1700766300
Name:TAROSSO REA, MARCELA
Entity type:Individual
Prefix:
First Name:MARCELA
Middle Name:
Last Name:TAROSSO REA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 JONES FERRY RD APT H5
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-2047
Mailing Address - Country:US
Mailing Address - Phone:919-240-1806
Mailing Address - Fax:
Practice Address - Street 1:120 DENTAL CIR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7450
Practice Address - Country:US
Practice Address - Phone:919-537-3511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program