Provider Demographics
NPI:1952723660
Name:DR MARINO AND ASSOCIATES INC
Entity Type:Organization
Organization Name:DR MARINO AND ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARLO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:216-541-6434
Mailing Address - Street 1:5 SEVERANCE CIR
Mailing Address - Street 2:STE 412
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1566
Mailing Address - Country:US
Mailing Address - Phone:216-541-6434
Mailing Address - Fax:216-541-6439
Practice Address - Street 1:5 SEVERANCE CIR
Practice Address - Street 2:STE 412
Practice Address - City:CLEVELAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1566
Practice Address - Country:US
Practice Address - Phone:216-541-6434
Practice Address - Fax:216-541-6439
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR MARINO AND ASSICIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-15
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty