Individual
DAMIAN MARIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1951 PINE HALL RD STE 200, STATE COLLEGE, PA 16801-5108
(814) 826-2055
Mailing address
1066 ROUTE 414 HWY, WATERVILLE, PA 17776-9511
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS039960
PA
Other
Enumeration date
10/04/2016
Last updated
10/04/2016
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