Provider Demographics
NPI:1982421269
Name:LINDA R MARINELLO
Entity type:Organization
Organization Name:LINDA R MARINELLO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MARINELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-645-2134
Mailing Address - Street 1:1678 BEACON ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-2179
Mailing Address - Country:US
Mailing Address - Phone:617-566-1007
Mailing Address - Fax:617-264-9713
Practice Address - Street 1:1678 BEACON ST STE 1
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-2179
Practice Address - Country:US
Practice Address - Phone:617-566-1007
Practice Address - Fax:617-264-9713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty