MEDICARE: MARINOFF & HILLIARD, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2372	AZ

General Provider Information

NPI Number	:	1619181104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARINOFF & HILLIARD, PC

Provider Business Mailing Address
First Line	:	1200 W WARNER RD
Second Line	:	SUITE B
City	:	CHANDLER
State	:	AZ
Zip	:	85224-2758
Country	:	US
Telephone Number	:	480-831-8800
Fax Number	:	480-899-9329

Provider Business Practice Location Address
First Line	:	1200 W WARNER RD
Second Line	:	SUITE B
City	:	CHANDLER
State	:	AZ
Zip	:	85224-2758
Country	:	US
Telephone Number	:	480-831-8800
Fax Number	:	480-899-9329

Authorized Official
Title or Position	:	SEC
Name	:	DR. JEAN E HILLIARD
Credential	:	DDS
Telephone Number	:	480-831-8800

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	01/09/2009

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