Provider Demographics
NPI:1093824617
Name:DRS MARINO NASSIF & ASSOCIATES INC
Entity Type:Organization
Organization Name:DRS MARINO NASSIF & ASSOCIATES INC
Other - Org Name:DRS RHODES RINALDI & ASSOC INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-920-8060
Mailing Address - Street 1:5507 MAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124
Mailing Address - Country:US
Mailing Address - Phone:440-473-3338
Mailing Address - Fax:440-473-1988
Practice Address - Street 1:5507 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124
Practice Address - Country:US
Practice Address - Phone:440-473-3338
Practice Address - Fax:440-473-1988
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DRS MARINO NASSIF & ASSOCIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-29
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH191821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2513739Medicaid