Provider Demographics
NPI:1114255924
Name:TESSLER, MARC J (DMD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:J
Last Name:TESSLER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 TADMUCK RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-3160
Mailing Address - Country:US
Mailing Address - Phone:978-392-9909
Mailing Address - Fax:
Practice Address - Street 1:66 TADMUCK RD
Practice Address - Street 2:SUITE 4
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3160
Practice Address - Country:US
Practice Address - Phone:978-392-9909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN174031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice