Provider Demographics
NPI:1366580938
Name:MARZ, RICHARD F (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:F
Last Name:MARZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 BRAMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-0847
Mailing Address - Country:US
Mailing Address - Phone:912-764-3724
Mailing Address - Fax:912-489-3721
Practice Address - Street 1:1130 BRAMPTON AVE
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-0847
Practice Address - Country:US
Practice Address - Phone:912-764-3724
Practice Address - Fax:912-489-3721
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-03
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0102281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice