Healthcare Provider Details

I. General information

NPI: 1760301691
Provider Name (Legal Business Name): MARZENA MAKAREWICZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 PEARL ST
BRAINTREE MA
02184-6521
US

IV. Provider business mailing address

11 WILDWOOD RD
PEMBROKE MA
02359-2535
US

V. Phone/Fax

Practice location:
  • Phone: 781-356-3030
  • Fax:
Mailing address:
  • Phone: 781-927-9922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH87516
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: