Provider Demographics
NPI:1083324461
Name:MARIANELLA ROMERO DMD PLLC
Entity Type:Organization
Organization Name:MARIANELLA ROMERO DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIANELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMERO-ZAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:203-764-0442
Mailing Address - Street 1:100 CHARLEMONT ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02461-1910
Mailing Address - Country:US
Mailing Address - Phone:203-764-0442
Mailing Address - Fax:
Practice Address - Street 1:1261 FURNACE BROOK PKWY STE 28
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4762
Practice Address - Country:US
Practice Address - Phone:203-764-0442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty