Provider Demographics
NPI:1669486247
Name:MARLETTE, MARC L (DMD)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:L
Last Name:MARLETTE
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 1:7303 US HIGHWAY 42
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1903
Mailing Address - Country:US
Mailing Address - Phone:859-283-0033
Mailing Address - Fax:859-283-0036
Practice Address - Street 1:7303 US HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1903
Practice Address - Country:US
Practice Address - Phone:859-283-0033
Practice Address - Fax:859-283-0036
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY72991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice