Provider Demographics
NPI:1093722639
Name:MARMO, MICHAEL STEPHEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STEPHEN
Last Name:MARMO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:660 NEWTOWN YARDLEY RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1759
Mailing Address - Country:US
Mailing Address - Phone:215-497-4977
Mailing Address - Fax:215-497-8858
Practice Address - Street 1:660 NEWTOWN YARDLEY RD
Practice Address - Street 2:SUITE 103
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1759
Practice Address - Country:US
Practice Address - Phone:215-497-4977
Practice Address - Fax:215-497-8858
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PADS029528L1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics