Provider Demographics
NPI:1649713843
Name:MARLEY M RINOLDO DDS PC
Entity type:Organization
Organization Name:MARLEY M RINOLDO DDS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARLEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:RINOLDO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:315-529-1973
Mailing Address - Street 1:6844 E GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13066-1031
Mailing Address - Country:US
Mailing Address - Phone:315-449-0711
Mailing Address - Fax:315-446-8394
Practice Address - Street 1:6844 E GENESEE ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NY
Practice Address - Zip Code:13066-1031
Practice Address - Country:US
Practice Address - Phone:315-449-0711
Practice Address - Fax:315-446-8394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1982837308OtherMARLEY M RINOLDO DDS PC