Provider Demographics
NPI:1811019144
Name:SCHWEINEBRATEN, MARIE C (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:C
Last Name:SCHWEINEBRATEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA90061223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics