Provider Demographics
NPI:1497392864
Name:MARCUCCI DENTAL INC
Entity Type:Organization
Organization Name:MARCUCCI DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDOORI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:856-393-2000
Mailing Address - Street 1:556 N HARDING HWY
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-8713
Mailing Address - Country:US
Mailing Address - Phone:856-697-2440
Mailing Address - Fax:
Practice Address - Street 1:556 N HARDING HWY
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-8713
Practice Address - Country:US
Practice Address - Phone:856-697-2440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental