Provider Demographics
NPI:1265616759
Name:MARCIA L. REMENTER, DMD, PA III
Entity type:Organization
Organization Name:MARCIA L. REMENTER, DMD, PA III
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:REMENTER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:919-477-3369
Mailing Address - Street 1:2430 S CHURCH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-5202
Mailing Address - Country:US
Mailing Address - Phone:336-513-4474
Mailing Address - Fax:
Practice Address - Street 1:2430 S CHURCH ST
Practice Address - Street 2:SUITE B
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5202
Practice Address - Country:US
Practice Address - Phone:336-513-4474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty