Provider Demographics
NPI:1912058181
Name:MAROCCO-CASEY, ANNE MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:MARIE
Last Name:MAROCCO-CASEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4959 ARLINGTON AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-2756
Mailing Address - Country:US
Mailing Address - Phone:951-689-0220
Mailing Address - Fax:951-689-2571
Practice Address - Street 1:4959 ARLINGTON AVE
Practice Address - Street 2:SUITE E
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-2756
Practice Address - Country:US
Practice Address - Phone:951-689-0220
Practice Address - Fax:951-689-2571
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA479431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice