Provider Demographics
NPI:1780325332
Name:TODD A. MARINO, DDS PLC
Entity type:Organization
Organization Name:TODD A. MARINO, DDS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-293-0495
Mailing Address - Street 1:6415 NORMANDY DR STE 1
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-8301
Mailing Address - Country:US
Mailing Address - Phone:989-793-9100
Mailing Address - Fax:989-793-9102
Practice Address - Street 1:6415 NORMANDY DR STE 1
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-8301
Practice Address - Country:US
Practice Address - Phone:989-793-9100
Practice Address - Fax:989-793-9102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty