Provider Demographics
NPI:1124127238
Name:MAROSKY, JOHN E (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:MAROSKY
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 E ALTO RD
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-3601
Mailing Address - Country:US
Mailing Address - Phone:765-455-2505
Mailing Address - Fax:765-455-2564
Practice Address - Street 1:112 E ALTO RD
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3601
Practice Address - Country:US
Practice Address - Phone:765-455-2505
Practice Address - Fax:765-455-2564
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120064011223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics