Provider Demographics
NPI:1033393624
Name:MARQUE MANAGEMENT LLC
Entity Type:Organization
Organization Name:MARQUE MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:M
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-622-6288
Mailing Address - Street 1:373 S WILLOW ST
Mailing Address - Street 2:SUITE D1-6
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-5751
Mailing Address - Country:US
Mailing Address - Phone:603-622-6288
Mailing Address - Fax:
Practice Address - Street 1:373 S WILLOW ST
Practice Address - Street 2:SUITE D1-6
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-5751
Practice Address - Country:US
Practice Address - Phone:603-622-6288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3568122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty