Provider Demographics
NPI:1962557397
Name:GLOBERMAN, MARC STUART (DDS)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:STUART
Last Name:GLOBERMAN
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 1:29990 KINGSWAY DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-1707
Mailing Address - Country:US
Mailing Address - Phone:248-661-2053
Mailing Address - Fax:
Practice Address - Street 1:7439 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:W BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4183
Practice Address - Country:US
Practice Address - Phone:248-626-3701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI12489122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist