Organization
CHARLES MARVIN, DDS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE LYNN MARVIN (OFFICE MANAGER)
(845) 354-4600
Entity
Organization
Contact information
Practice address
978 ROUTE 45, NORTHSIDE PLAZA, SUITE 207, POMONA, NY 10970-3521
(845) 354-4600
(845) 354-4653
Mailing address
978 ROUTE 45, NORTHSIDE PLAZA, SUITE 207, POMONA, NY 10970-3521
(845) 354-4600
(845) 354-4653
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
048411-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02 042 244
—
NY
Enumeration date
01/29/2007
Last updated
05/11/2009
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