Provider Demographics
NPI:1851169213
Name:NESSLER, MARINA (RDH)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:NESSLER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6712 FALLS RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:COLLEGE GROVE
Mailing Address - State:TN
Mailing Address - Zip Code:37046-1412
Mailing Address - Country:US
Mailing Address - Phone:615-613-3910
Mailing Address - Fax:
Practice Address - Street 1:6712 FALLS RIDGE LN
Practice Address - Street 2:
Practice Address - City:COLLEGE GROVE
Practice Address - State:TN
Practice Address - Zip Code:37046-1412
Practice Address - Country:US
Practice Address - Phone:615-613-3910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDH0000006189124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty