Provider Demographics
NPI:1942601935
Name:PM ORTHODONTICS, PA
Entity Type:Organization
Organization Name:PM ORTHODONTICS, PA
Other - Org Name:MARCO A. PINTO
Other - Org Type:Other Name
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:A
Authorized Official - Last Name:PINTO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:915-502-0277
Mailing Address - Street 1:9398 VISCOUNT BLVD STE 3A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-8028
Mailing Address - Country:US
Mailing Address - Phone:915-502-0277
Mailing Address - Fax:915-975-8032
Practice Address - Street 1:9398 VISCOUNT BLVD STE 3A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-8028
Practice Address - Country:US
Practice Address - Phone:915-502-0277
Practice Address - Fax:915-975-8032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX257161223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty