Provider Demographics
NPI:1780693978
Name:MARX, CHARLES S (DDS)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:S
Last Name:MARX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11152 HURON ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80234-4321
Mailing Address - Country:US
Mailing Address - Phone:303-452-1563
Mailing Address - Fax:303-452-1571
Practice Address - Street 1:11152 HURON ST
Practice Address - Street 2:SUITE 104
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234-4321
Practice Address - Country:US
Practice Address - Phone:303-452-1563
Practice Address - Fax:303-452-1571
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO1052821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice