Provider Demographics
NPI:1467422196
Name:PINKAS, MARINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARINA
Middle Name:
Last Name:PINKAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-1172
Mailing Address - Country:US
Mailing Address - Phone:781-784-4888
Mailing Address - Fax:781-784-5522
Practice Address - Street 1:450 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067-1172
Practice Address - Country:US
Practice Address - Phone:781-784-4888
Practice Address - Fax:781-784-5522
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20803122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1301128Medicaid