Provider Demographics
NPI:1043313364
Name:THE DENTAL OFFICES OF DR MARCUS S TAPPAN & ASSOCIATES PC
Entity Type:Organization
Organization Name:THE DENTAL OFFICES OF DR MARCUS S TAPPAN & ASSOCIATES PC
Other - Org Name:DR MARCUS S TAPPAN & ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:S
Authorized Official - Last Name:TAPPAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-565-8212
Mailing Address - Street 1:8611 SECOND AVE SUITE 101
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-6377
Mailing Address - Country:US
Mailing Address - Phone:301-565-8212
Mailing Address - Fax:301-565-9458
Practice Address - Street 1:8611 SECOND AVE SUITE 101
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-6377
Practice Address - Country:US
Practice Address - Phone:301-565-8212
Practice Address - Fax:301-565-9458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10168122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty