Provider Demographics
NPI:1134305055
Name:MARKS, JENNIFER (DDS)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:MARKS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:674 MERRIMON AVE
Mailing Address - Street 2:SUITE 230 A
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-3586
Mailing Address - Country:US
Mailing Address - Phone:828-255-8447
Mailing Address - Fax:828-255-6762
Practice Address - Street 1:674 MERRIMON AVE
Practice Address - Street 2:SUITE 230 A
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-3586
Practice Address - Country:US
Practice Address - Phone:828-255-8447
Practice Address - Fax:828-255-6762
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC75941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice