Provider Demographics
NPI:1790146876
Name:MARSCHIK, MARYANNE (DDS)
Entity Type:Individual
Prefix:
First Name:MARYANNE
Middle Name:
Last Name:MARSCHIK
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 1:880 CASS ST STE 207
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2909
Mailing Address - Country:US
Mailing Address - Phone:831-372-4411
Mailing Address - Fax:831-372-3954
Practice Address - Street 1:880 CASS ST STE 207
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2909
Practice Address - Country:US
Practice Address - Phone:831-372-4411
Practice Address - Fax:831-372-3954
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36175122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist