Provider Demographics
NPI:1225278500
Name:MICHAEL V. MARCHESE, D M D, P C
Entity Type:Organization
Organization Name:MICHAEL V. MARCHESE, D M D, P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:V
Authorized Official - Last Name:MARCHESE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:717-561-0011
Mailing Address - Street 1:5400 CHAMBERS HILL RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-2545
Mailing Address - Country:US
Mailing Address - Phone:717-561-0011
Mailing Address - Fax:717-561-0016
Practice Address - Street 1:5400 CHAMBERS HILL RD
Practice Address - Street 2:SUITE B
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-2545
Practice Address - Country:US
Practice Address - Phone:717-561-0011
Practice Address - Fax:717-561-0016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-26
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0356641223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty