Organization
C MARCELLO DDS, MSD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTY MARCELLO DDS (DENTIST)
(985) 446-3754
Entity
Organization
Contact information
Practice address
156 W MAIN ST, THIBODAUX, LA 70301-5216
(985) 446-3754
Mailing address
156 W MAIN ST, THIBODAUX, LA 70301-5216
(985) 446-3754
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1865630
—
LA
Enumeration date
05/10/2022
Last updated
05/10/2022
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