Provider Demographics
NPI:1649329087
Name:MARSETTE A VONA DMD PC
Entity type:Organization
Organization Name:MARSETTE A VONA DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARSETTE
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:VONA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:315-853-3995
Mailing Address - Street 1:5 SOUTH PARK ROW
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NY
Mailing Address - Zip Code:13323
Mailing Address - Country:US
Mailing Address - Phone:315-853-3995
Mailing Address - Fax:315-853-3493
Practice Address - Street 1:5 SOUTH PARK ROW
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NY
Practice Address - Zip Code:13323
Practice Address - Country:US
Practice Address - Phone:315-853-3995
Practice Address - Fax:315-853-3493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYDDS 028763122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty