Individual
DR. MARYBETH MARCINCIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D, M.S.
Contact information
Practice address
1414 MILLARD ST, BETHLEHEM, PA 18018-2632
(610) 691-1461
(610) 691-4184
Mailing address
1414 MILLARD ST, BETHLEHEM, PA 18018-2632
(610) 691-1461
(610) 691-4184
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS026773L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23-2710202
FEDERAL TAX ID
PA
01
—
DS026773L
DENTAL LICENSE NUMBER
PA
Enumeration date
08/05/2006
Last updated
07/08/2007
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