Provider Demographics
NPI:1720231327
Name:MARABLE, HENRY TWA DEVOM (DDS)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:TWA DEVOM
Last Name:MARABLE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1315 DELAUNEY AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-2367
Mailing Address - Country:US
Mailing Address - Phone:706-322-9599
Mailing Address - Fax:706-322-8332
Practice Address - Street 1:1315 DELAUNAY AVENUE
Practice Address - Street 2:SUITE 201 B
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901
Practice Address - Country:US
Practice Address - Phone:706-221-4433
Practice Address - Fax:706-221-4495
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GADN0137811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice