=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760301691
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARZENA MAKAREWICZ
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2026
-----------------------------------------------------
Last Update Date | 07/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 102 PEARL ST
-----------------------------------------------------
City | BRAINTREE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02184-6521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-356-3030
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11 WILDWOOD RD
-----------------------------------------------------
City | PEMBROKE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02359-2535
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-927-9922
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 124Q00000X
-----------------------------------------------------
Taxonomy Name | Dental Hygienist
-----------------------------------------------------
License Number | DH87516
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------