Provider Demographics
NPI:1720454432
Name:KWIATKOWSKI AND MARSCHIK PROF DENTAL CORP
Entity Type:Organization
Organization Name:KWIATKOWSKI AND MARSCHIK PROF DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR/ COOWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARYANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSCHIK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:831-372-4411
Mailing Address - Street 1:880 CASS ST
Mailing Address - Street 2:SUITE#207
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2947
Mailing Address - Country:US
Mailing Address - Phone:831-372-4411
Mailing Address - Fax:831-372-3954
Practice Address - Street 1:880 CASS ST
Practice Address - Street 2:SUITE#207
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2947
Practice Address - Country:US
Practice Address - Phone:831-372-4411
Practice Address - Fax:831-372-3954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA036175261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental