Provider Demographics
NPI:1699926717
Name:CENTRAL SQUARE DENTAL ASSOCIATES
Entity type:Organization
Organization Name:CENTRAL SQUARE DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:MARRANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-214-0666
Mailing Address - Street 1:3033 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:CENTRAL SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:13036-2611
Mailing Address - Country:US
Mailing Address - Phone:315-668-5600
Mailing Address - Fax:
Practice Address - Street 1:3033 EAST AVE
Practice Address - Street 2:
Practice Address - City:CENTRAL SQUARE
Practice Address - State:NY
Practice Address - Zip Code:13036-2611
Practice Address - Country:US
Practice Address - Phone:315-668-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CICERO DENTAL ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty