Provider Demographics
NPI:1730122920
Name:MARCUS, EDWARD STEVEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:STEVEN
Last Name:MARCUS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6745 BARRINGTON PL
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2780
Mailing Address - Country:US
Mailing Address - Phone:317-845-1236
Mailing Address - Fax:317-846-7312
Practice Address - Street 1:9302 N MERIDIAN ST
Practice Address - Street 2:SUITE 205
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1873
Practice Address - Country:US
Practice Address - Phone:317-846-2131
Practice Address - Fax:317-846-7312
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN7165122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist