Provider Demographics
NPI:1922384486
Name:MARCY, MARGARET ANN (RDH)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:ANN
Last Name:MARCY
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:PO BOX 6
Mailing Address - Street 2:2718 ST, CROIX TRAIL SO
Mailing Address - City:AFTON
Mailing Address - State:MN
Mailing Address - Zip Code:55001-0006
Mailing Address - Country:US
Mailing Address - Phone:612-819-8533
Mailing Address - Fax:
Practice Address - Street 1:2718 SAINT CROIX TRL S
Practice Address - Street 2:
Practice Address - City:AFTON
Practice Address - State:MN
Practice Address - Zip Code:55001-9425
Practice Address - Country:US
Practice Address - Phone:612-819-8533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-28
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNH5347124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist