Provider Demographics
NPI:1740403369
Name:MARINESCU, DANIELA (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIELA
Middle Name:
Last Name:MARINESCU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1291 BOSTON POST RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-3476
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1291 BOSTON POST RD
Practice Address - Street 2:SUITE 103
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-3476
Practice Address - Country:US
Practice Address - Phone:203-245-0409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0094701223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004236122Medicaid