Provider Demographics
NPI:1831122845
Name:MARINAK & GLOSSNER DDS PC
Entity Type:Organization
Organization Name:MARINAK & GLOSSNER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:MARINAK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:717-737-7422
Mailing Address - Street 1:19 S 22ND ST
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011
Mailing Address - Country:US
Mailing Address - Phone:717-737-7422
Mailing Address - Fax:717-975-2301
Practice Address - Street 1:19 S 22ND ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011
Practice Address - Country:US
Practice Address - Phone:717-737-7422
Practice Address - Fax:717-975-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS018402L122300000X
PADS030329L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty