Provider Demographics
NPI:1013772615
Name:C.M.Z. FAMILY DENITSTRY
Entity Type:Organization
Organization Name:C.M.Z. FAMILY DENITSTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-728-5170
Mailing Address - Street 1:18 CENTRAL SQ
Mailing Address - Street 2:
Mailing Address - City:WEST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02379-1779
Mailing Address - Country:US
Mailing Address - Phone:508-583-1883
Mailing Address - Fax:
Practice Address - Street 1:18 CENTRAL SQ
Practice Address - Street 2:
Practice Address - City:WEST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02379-1779
Practice Address - Country:US
Practice Address - Phone:508-583-1883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental