Individual
MICHAEL JOSEPH MARCELLO II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS,MS
Contact information
Practice address
117 SAINT MICHAEL ST, THIBODAUX, LA 70301-3437
(985) 625-3636
Mailing address
824 RIDGEFIELD RD, THIBODAUX, LA 70301-2726
(985) 625-3636
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
5947
LA
Other
Enumeration date
09/01/2010
Last updated
09/08/2016
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