Provider Demographics
NPI:1962777102
Name:ANNETTE MERLINO DMD, INC
Entity type:Organization
Organization Name:ANNETTE MERLINO DMD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MERLINO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:724-468-8502
Mailing Address - Street 1:243 HYDE PARK RD
Mailing Address - Street 2:
Mailing Address - City:LEECHBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15656-9670
Mailing Address - Country:US
Mailing Address - Phone:724-845-2400
Mailing Address - Fax:724-845-2412
Practice Address - Street 1:243 HYDE PARK RD
Practice Address - Street 2:
Practice Address - City:LEECHBURG
Practice Address - State:PA
Practice Address - Zip Code:15656-9670
Practice Address - Country:US
Practice Address - Phone:724-845-2400
Practice Address - Fax:724-845-2412
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANNETTE MERLINO DMD, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0263890122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty