Provider Demographics
NPI:1013258441
Name:MARRE, ADAM CHARLES (MD, DDS)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:CHARLES
Last Name:MARRE
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Gender:M
Credentials:MD, DDS
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Mailing Address - Street 1:1855 SAN MIGUEL DR
Mailing Address - Street 2:STE 25
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5298
Mailing Address - Country:US
Mailing Address - Phone:925-934-5565
Mailing Address - Fax:925-934-6003
Practice Address - Street 1:1855 SAN MIGUEL DR
Practice Address - Street 2:STE 25
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5298
Practice Address - Country:US
Practice Address - Phone:925-934-5565
Practice Address - Fax:925-934-6003
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA153496204E00000X
KY93621223S0112X
CAOMS1201223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery