Ulysses Luther Marable III, DMD
Individual provider Active NPI General Practice Dentistry · Fort Valley, GA
NPI 1891905683 · NPPES record last updated Jul 8, 2013
Key facts
- NPI
- 1891905683
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DN013223 (GA)
- Practice address
- 1030 Peach Pkwy
Suite 99
Fort Valley, GA 31030-8181 - Phone
- (478) 825-3000
- Fax
- (478) 825-3099
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN013223 | GA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN013223 | GA | Yes |
Addresses
Primary practice location
1030 Peach Pkwy
Suite 99
Fort Valley, GA 31030-8181
Mailing address
PO Box 1057
Fort Valley, GA 31030-1057
Phone (478) 825-3000
Other providers in Fort Valley, GA
- Kingdom Physical Therapy and Wellness LLC
- Druscilla Lockett
- Janet Kay Logan
- Macon Occupational Medicine
- Chatity M Mallard
- Martin Physical Therapy and Wellness, Inc.
- Dawson Kendrick Mathews
- Kali McCalvin
- Frederick McLaughlin Sr.
- Shavon McWilliams
All providers in Fort Valley, GA · General Practice Dentistry in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2013. 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.