Provider Demographics
NPI:1891790473
Name:DAHMS, MARILYN A (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:A
Last Name:DAHMS
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 1:2770 CARPENTER RD
Mailing Address - Street 2:STE 120
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-4104
Mailing Address - Country:US
Mailing Address - Phone:734-971-6400
Mailing Address - Fax:734-971-4427
Practice Address - Street 1:2770 CARPENTER RD
Practice Address - Street 2:STE 120
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-4104
Practice Address - Country:US
Practice Address - Phone:734-971-6400
Practice Address - Fax:734-971-4427
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010127791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice