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Organization

ANTHONY MARINO D.D.S., M.S. PROFESSIONAL CORORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. HEATHER COREN RE RDA (RDA / FRONT OFFICE ASSISTANT)
(707) 448-6271
Entity
Organization

Contact information

Practice address
1010 EMPIRE STREET, FAIRFIELD, CA 94533-5707
(707) 448-6271
(707) 448-4742
Mailing address
290 ALAMO DRIVE, SUITE B, VACAVILLE, CA 95688-4245
(707) 448-6271
(707) 448-4742

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
34521
CA

Other

Enumeration date
09/13/2012
Last updated
09/13/2012
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