Provider Demographics
NPI:1447475884
Name:MARINELLO, LINDA ROSE
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:ROSE
Last Name:MARINELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 FULLER STREET
Mailing Address - Street 2:#3 APT
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-2404
Mailing Address - Country:US
Mailing Address - Phone:617-645-2134
Mailing Address - Fax:617-566-0037
Practice Address - Street 1:1678 BEACON ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-2113
Practice Address - Country:US
Practice Address - Phone:617-566-1007
Practice Address - Fax:617-924-2999
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA190891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice