Provider Demographics
NPI:1902814999
Name:LEVIN, MARC A (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:A
Last Name:LEVIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1601 WALNUT ST
Mailing Address - Street 2:STE 1414
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19102
Mailing Address - Country:US
Mailing Address - Phone:215-241-0700
Mailing Address - Fax:215-563-1707
Practice Address - Street 1:1601 WALNUT ST
Practice Address - Street 2:#1414
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19102
Practice Address - Country:US
Practice Address - Phone:215-241-0700
Practice Address - Fax:215-563-1707
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PADS022256L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice