Provider Demographics
NPI:1144374935
Name:MARSHALL S HUMES DDS & ANTHONY PITROWSKI MD, DMD, INC.
Entity type:Organization
Organization Name:MARSHALL S HUMES DDS & ANTHONY PITROWSKI MD, DMD, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:PITROWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD DMD
Authorized Official - Phone:805-928-7611
Mailing Address - Street 1:201 N COLLEGE DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-4614
Mailing Address - Country:US
Mailing Address - Phone:805-928-7611
Mailing Address - Fax:805-349-8551
Practice Address - Street 1:201 N COLLEGE DR
Practice Address - Street 2:SUITE 202
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-4614
Practice Address - Country:US
Practice Address - Phone:805-928-7611
Practice Address - Fax:805-349-8551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOM516204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty