Provider Demographics
NPI:1437330859
Name:CIRELLI, MARC ANTHONY (DMD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:ANTHONY
Last Name:CIRELLI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:MARC
Other - Middle Name:ANTHONY
Other - Last Name:CIRELLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:465 W PECKHAM LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-5305
Mailing Address - Country:US
Mailing Address - Phone:775-827-6666
Mailing Address - Fax:775-827-0362
Practice Address - Street 1:465 W PECKHAM LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-5305
Practice Address - Country:US
Practice Address - Phone:775-827-6666
Practice Address - Fax:775-827-0362
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5632122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist