Provider Demographics
NPI:1043289481
Name:BARNDT, MARJORIE WOOD (DMD, MDSC)
Entity type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:WOOD
Last Name:BARNDT
Suffix:
Gender:F
Credentials:DMD, MDSC
Other - Prefix:DR
Other - First Name:MARJORIE
Other - Middle Name:COWEE
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:7 MAYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:OLD LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06371-1544
Mailing Address - Country:US
Mailing Address - Phone:843-986-4144
Mailing Address - Fax:
Practice Address - Street 1:112 CROSS ROAD
Practice Address - Street 2:COASTAL CT DENTISTRY
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385
Practice Address - Country:US
Practice Address - Phone:860-447-1787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213711223P0700X
SC44381223P0700X
CT0114211223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics