Provider Demographics
NPI:1841497427
Name:MARVEL, JAMIE L (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:L
Last Name:MARVEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 W HASKELL ST
Mailing Address - Street 2:
Mailing Address - City:WINNEMUCCA
Mailing Address - State:NV
Mailing Address - Zip Code:89445-6700
Mailing Address - Country:US
Mailing Address - Phone:775-623-2364
Mailing Address - Fax:
Practice Address - Street 1:465 W HASKELL ST
Practice Address - Street 2:
Practice Address - City:WINNEMUCCA
Practice Address - State:NV
Practice Address - Zip Code:89445-6700
Practice Address - Country:US
Practice Address - Phone:776-623-2364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4821122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist