Provider Demographics
NPI:1871011957
Name:REBECCA A. MARSH, DDS, APC
Entity Type:Organization
Organization Name:REBECCA A. MARSH, DDS, APC
Other - Org Name:HILLCREST DENTAL ARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-564-7156
Mailing Address - Street 1:306 WALNUT AVE STE 23
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-4980
Mailing Address - Country:US
Mailing Address - Phone:619-564-7156
Mailing Address - Fax:619-564-7468
Practice Address - Street 1:306 WALNUT AVE STE 23
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4980
Practice Address - Country:US
Practice Address - Phone:619-564-7156
Practice Address - Fax:619-564-7468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-08
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50317261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental