Provider Demographics
NPI:1285658948
Name:MARGIOTTI, EUGENE ANTHONY (DDS)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:ANTHONY
Last Name:MARGIOTTI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 MERIDIAN PARKE LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-9426
Mailing Address - Country:US
Mailing Address - Phone:317-859-8100
Mailing Address - Fax:317-859-8300
Practice Address - Street 1:385 MERIDIAN PARKE LN
Practice Address - Street 2:SUITE B
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-9426
Practice Address - Country:US
Practice Address - Phone:317-859-8100
Practice Address - Fax:317-859-8300
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120092491223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics