Provider Demographics
NPI:1295464352
Name:BERNADETTE MARINO DDS PLLC
Entity Type:Organization
Organization Name:BERNADETTE MARINO DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:585-429-6943
Mailing Address - Street 1:139 SPENCERPORT RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14606-5207
Mailing Address - Country:US
Mailing Address - Phone:585-429-6943
Mailing Address - Fax:585-429-7012
Practice Address - Street 1:139 SPENCERPORT RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14606-5207
Practice Address - Country:US
Practice Address - Phone:585-429-6943
Practice Address - Fax:585-429-7012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty