| Charles Marvin, Dds, P.c. | |
|
978 Route 45 Northside Plaza, Suite 207 Pomona NY 10970-3521 | |
| (845) 354-4600 | |
| (845) 354-4653 |
| Full Name | Charles Marvin, Dds, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 978 Route 45, Pomona, New York |
| Authorized Official Name and Position | Michelle Lynn Marvin (OFFICE MANAGER) |
| Authorized Official Contact | 8453544600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Marvin, Dds, P.c. 978 Route 45 Northside Plaza, Suite 207 Pomona NY 10970-3521 Ph: (845) 354-4600 | Charles Marvin, Dds, P.c. 978 Route 45 Northside Plaza, Suite 207 Pomona NY 10970-3521 Ph: (845) 354-4600 |
| NPI Number | 1326184508 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 05/11/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326184508 | NPI | - | NPPES |
| 02 042 244 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 048411-1 (New York) | Primary |
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