Provider Demographics
NPI:1609072552
Name:MARIE C. SCHWEINEBRATEN, DMDPC
Entity Type:Organization
Organization Name:MARIE C. SCHWEINEBRATEN, DMDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHWEINEBRATEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-446-2640
Mailing Address - Street 1:3953 HOLCOMB BRIDGE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-2207
Mailing Address - Country:US
Mailing Address - Phone:770-446-2640
Mailing Address - Fax:770-446-6301
Practice Address - Street 1:3953 HOLCOMB BRIDGE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-2207
Practice Address - Country:US
Practice Address - Phone:770-446-2640
Practice Address - Fax:770-446-6301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA90061223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty