Marcie Mliss Maxham in Fort Bragg - Dentist
Marcie Mliss Maxham - NPI 1568594216
Marcie Mliss Maxham is a Dentist in Fort Bragg, California. Marcie Mliss Maxham practices all healthcare services and medical treatments related to Dentist. The NPI Number for Marcie Mliss Maxham is 1568594216. The last update date is 2007-07-08.
Marcie Mliss Maxham's current location address is 205 South Street, Fort Bragg, California. You can contact this provider via phone number 7079643786 and fax number 7079612722. The mailing address for Marcie Mliss Maxham is 205 South Street, Fort Bragg, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Marcie Mliss Maxham |
|---|---|
| Address | 205 South Street, Fort Bragg, California |
| Phone Number | 7079643786 |
| Fax Number | 7079612722 |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1568594216 |
|---|---|
| Provider Enumeration Date | 2007-03-09 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 205 South Street |
|---|---|
| City | Fort Bragg |
| State | California (CA) |
| Post Code | 954375540 |
| Phone Number | 7079643786 |
| Fax Number | 7079612722 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | DG031665 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| FHC03967F | CA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Marcie Mliss Maxham by the Centers for Medicare & Medicaid Services?
The Marcie Mliss Maxham has been assigned the NPI (National Provider Identifier) 1568594216. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Marcie Mliss Maxham's facilities are geographically located?
The facilities of Marcie Mliss Maxham are physically situated at the following location: 205 South Street, Fort Bragg, CA, 954375540.
What is Marcie Mliss Maxham's specialized field of practice, and what is the corresponding taxonomy classification code?
The Marcie Mliss Maxham's area of specialization is Dentist, and the corresponding taxonomy code that categorizes this field of practice is 122300000X.
When did Marcie Mliss Maxham receive its 1568594216 assignment?
The Marcie Mliss Maxham was assigned its 1568594216 on 2007-03-09, which is the date when this unique identifier was issued to the organization.
As of what date were the details related to Marcie Mliss Maxham most recently updated or revised?
The information pertaining to Marcie Mliss Maxham, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.
NPI Number: 1336142389
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