Provider Demographics
NPI:1639232960
Name:MARKS DAVIS, MARILYN RENEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:RENEE
Last Name:MARKS DAVIS
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 1:1470 E VALENTINE CIR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-3100
Mailing Address - Country:US
Mailing Address - Phone:330-455-0706
Mailing Address - Fax:
Practice Address - Street 1:1470 E VALENTINE CIR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-3100
Practice Address - Country:US
Practice Address - Phone:330-455-0706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300182491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice