Provider Demographics
NPI:1407130719
Name:DRS. MARINO, NASSIF & ASSOCIATES INC.
Entity Type:Organization
Organization Name:DRS. MARINO, NASSIF & ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANANGER/RDH
Authorized Official - Prefix:
Authorized Official - First Name:CAMILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-920-8060
Mailing Address - Street 1:381 DARROW RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-3057
Mailing Address - Country:US
Mailing Address - Phone:330-784-7285
Mailing Address - Fax:
Practice Address - Street 1:381 DARROW RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-3057
Practice Address - Country:US
Practice Address - Phone:330-784-7285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DRS. MARINO, NASSIF & ASSOCIATES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH191821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty