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Individual

JOSEPH A MARINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1351 MAIN ST, BROCKTON, MA 02301
(508) 587-2000
(508) 580-3552
Mailing address
1351 MAIN ST, BROCKTON, MA 02301
(508) 587-2000
(508) 580-3552

Taxonomy

Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
17166
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0277088
MA
Enumeration date
05/23/2006
Last updated
05/04/2012
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