Provider Demographics
NPI:1508936162
Name:PEARLSTEIN, MARC EVAN (DMD MSD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:EVAN
Last Name:PEARLSTEIN
Suffix:
Gender:M
Credentials:DMD MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 STANLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907
Mailing Address - Country:US
Mailing Address - Phone:781-254-0945
Mailing Address - Fax:
Practice Address - Street 1:38 STANLEY ROAD
Practice Address - Street 2:
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01907
Practice Address - Country:US
Practice Address - Phone:781-254-0945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA190421223P0300X
NH34201223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics