Provider Demographics
NPI:1033127501
Name:MARCHESE, JOSEPH ANTHONY JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:MARCHESE
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 NORTH LESLIE ST
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-3851
Mailing Address - Country:US
Mailing Address - Phone:919-735-0124
Mailing Address - Fax:919-735-9808
Practice Address - Street 1:515 S CASWELL ST
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:NC
Practice Address - Zip Code:28551-2005
Practice Address - Country:US
Practice Address - Phone:252-566-9616
Practice Address - Fax:252-566-4910
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC62411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7995470Medicaid
NC7995470Medicaid