Provider Demographics
NPI:1336207455
Name:MARION, DOUGLAS L (DDS)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:L
Last Name:MARION
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 NORTH FRANKLIN TURNPIKE
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1661
Mailing Address - Country:US
Mailing Address - Phone:201-825-7677
Mailing Address - Fax:201-825-9303
Practice Address - Street 1:116 NORTH FRANKLIN TURNPIKE
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1661
Practice Address - Country:US
Practice Address - Phone:201-825-7677
Practice Address - Fax:201-825-9303
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ99481223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics