| Organization Name: | MARCIA L. PRESTON DDS PC PRESTON FAMILY DENTAL |
| NPI Number: | 1609061233 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARCIA LYNN PRESTON (DENTIST) |
| Mailing Address: | 604 E Elm St Republic |
| State: | MO US |
| Postal Code: | 657381552 |
| Phone Number: | 4177327874 |
| Fax Number: | 4177325084 |
| NPI Enumeration Date: | 09/06/2007 |
| NPI Last Update Date: | 06/19/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 2002011186 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |