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General NPI Number Information
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NPI Number | 1679196679
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Entity Type | Organization
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Legal Business Name | PETER D MARO JR D M D M S P C
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Dates
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Enumeration Date | 05/26/2020
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Last Update Date | 06/29/2020
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Provider Practice Location Address
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Address Line | 262 PURCHASE ST
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City | RYE
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State | NY
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Zip | 10580-2169
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Country | US
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Telephone | 914-967-2277
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Fax | 914-967-2292
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Provider Business Mailing Address
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Address Line | 6 BEACH DR
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City | DARIEN
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State | CT
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Zip | 06820-5608
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Country | US
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Telephone | 203-829-4614
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PETER DANIEL MARO JR.
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Credential | DMD
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Telephone | 914-967-2277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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