Provider Demographics
NPI:1184154080
Name:MARQUIS, MATTHEW RAYMOND (DMD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:RAYMOND
Last Name:MARQUIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CHESTNUT ST APT 2308
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-1878
Mailing Address - Country:US
Mailing Address - Phone:603-502-4853
Mailing Address - Fax:
Practice Address - Street 1:2 MADISON AVE
Practice Address - Street 2:
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-1944
Practice Address - Country:US
Practice Address - Phone:603-668-5333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH043171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice