Provider Demographics
NPI:1922341296
Name:JORGE A MARQUIS DDS PA
Entity Type:Organization
Organization Name:JORGE A MARQUIS DDS PA
Other - Org Name:MARQUIS DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:MARQUIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-656-2200
Mailing Address - Street 1:14943 DUNWOODY BND
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-1870
Mailing Address - Country:US
Mailing Address - Phone:281-250-9549
Mailing Address - Fax:
Practice Address - Street 1:6037 N FRY RD
Practice Address - Street 2:SUITE 162
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-1802
Practice Address - Country:US
Practice Address - Phone:281-656-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
17098122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty