Provider Demographics
NPI:1982947719
Name:ROSS A. MARLEY, DMD, LLC
Entity Type:Organization
Organization Name:ROSS A. MARLEY, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-747-6050
Mailing Address - Street 1:423 HALIBUT POINT RD
Mailing Address - Street 2:
Mailing Address - City:SITKA
Mailing Address - State:AK
Mailing Address - Zip Code:99835-7301
Mailing Address - Country:US
Mailing Address - Phone:907-747-6050
Mailing Address - Fax:907-747-3706
Practice Address - Street 1:423 HALIBUT POINT RD
Practice Address - Street 2:
Practice Address - City:SITKA
Practice Address - State:AK
Practice Address - Zip Code:99835-7301
Practice Address - Country:US
Practice Address - Phone:907-747-6050
Practice Address - Fax:907-747-3706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-29
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1311122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty