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General NPI Number Information
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NPI Number | 1649329087
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Entity Type | Organization
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Legal Business Name | MARSETTE A VONA DMD PC
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5 SOUTH PARK ROW
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City | CLINTON
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State | NY
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Zip | 13323
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Country | US
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Telephone | 315-853-3995
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Fax | 315-853-3493
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Provider Business Mailing Address
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Address Line | 5 SOUTH PARK ROW
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City | CLINTON
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State | NY
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Zip | 13323
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Country | US
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Telephone | 315-853-3995
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Fax | 315-853-3493
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARSETTE ARTHUR VONA
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Credential | DMD
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Telephone | 315-853-3995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DDS 028763
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License Number State | NY
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