Provider Demographics
NPI:1730246166
Name:DR ROBERT G MARX DDS & ASSOCIATES LLC
Entity type:Organization
Organization Name:DR ROBERT G MARX DDS & ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:MARX
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:816-452-2000
Mailing Address - Street 1:5708 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64118-3962
Mailing Address - Country:US
Mailing Address - Phone:816-452-2000
Mailing Address - Fax:816-452-4069
Practice Address - Street 1:5708 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64118-3962
Practice Address - Country:US
Practice Address - Phone:816-452-2000
Practice Address - Fax:816-452-4069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0126901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty