Provider Demographics
NPI:1295014827
Name:MARQUETTE S.B., LLC
Entity Type:Organization
Organization Name:MARQUETTE S.B., LLC
Other - Org Name:MARQUETTE DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:O
Authorized Official - Last Name:BELCHER
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:713-777-9865
Mailing Address - Street 1:8323 SOUTHWEST FWY STE 610
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1609
Mailing Address - Country:US
Mailing Address - Phone:713-777-9865
Mailing Address - Fax:713-777-5250
Practice Address - Street 1:8323 SOUTHWEST FWY STE 610
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1609
Practice Address - Country:US
Practice Address - Phone:713-777-9865
Practice Address - Fax:713-777-5250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-13
Last Update Date:2011-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX162401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty