Marjorie J Risser, DMD
Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Rock Hill, SC
NPI 1215917687 · NPPES record last updated Oct 16, 2007
Key facts
- NPI
- 1215917687
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- SC3371 (SC)
- Practice address
- 372 S Herlong Ave
Rock Hill, SC 29732-1160 - Phone
- (803) 324-1160
- Fax
- (803) 324-2456
- NPI assigned
- Jan 20, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC3371 | SC | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Center for Oral & Maxillofacial Surgery | Oral and Maxillofacial Surgery | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | SC3371 | SC | Yes |
Addresses
Primary practice location
372 S Herlong Ave
Rock Hill, SC 29732-1160
Mailing address
372 S Herlong Ave
Rock Hill, SC 29732-1160
Phone (803) 324-1160
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Z33713 | Medicaid | SC |
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- Meleane Riley
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All providers in Rock Hill, SC · Oral and Maxillofacial Surgery (Dentist) in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.