Provider Demographics
NPI:1023475001
Name:MAERZ, RACHAEL
Entity type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:
Last Name:MAERZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1734 QUARRY VW
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-4959
Mailing Address - Country:US
Mailing Address - Phone:573-489-2782
Mailing Address - Fax:
Practice Address - Street 1:1734 QUARRY VW
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-4959
Practice Address - Country:US
Practice Address - Phone:573-489-2782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3583122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist