Provider Demographics
NPI:1366802878
Name:MELINDA MARINO DDS INC
Entity type:Organization
Organization Name:MELINDA MARINO DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:KAPLOW
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-578-0800
Mailing Address - Street 1:9910 MIRA MESA BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1066
Mailing Address - Country:US
Mailing Address - Phone:858-578-0800
Mailing Address - Fax:858-578-0444
Practice Address - Street 1:9910 MIRA MESA BLVD STE D
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1066
Practice Address - Country:US
Practice Address - Phone:858-578-0800
Practice Address - Fax:858-578-0444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-25
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty