Marin, Lisa G

Marin, Lisa G is an individual health care provider with primary practice located at 1430 John Wesley Gilbert Drive , Augusta GA 30912-0001. She recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as her primary health care specialty. Marin, Lisa G can be contacted via phone (706) 721-9744.

Contact Information

Primary practice address
1430 John Wesley Gilbert Drive Augusta GA 30912-0001
Phone: (706) 721-9744
Fax: (706) 721-6778
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 046876 New York
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X DN010898 Georgia

Profile Details

NPI number 1578659967
LBN Legal business name Marin, Lisa G
Credentials DMD, MD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2006
Last updated Apr 19th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578659967 NPPES
New York MEDICAID 02530936

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