Maryniuk, George A
Maryniuk, George A is an sole proprietor health care provider with primary practice located at 209 Harvard St Suite 302, Brookline MA 02446-5071. He recently has only one registered license in Dental Providers / Prosthodontics, which is considered as his primary health care specialty. Maryniuk, George A can be contacted via phone (617) 566-4108.Contact Information
Primary practice address
209 Harvard St Suite 302
Brookline MA 02446-5071
Phone: (617) 566-4108
Fax: (617) 566-4142
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Prosthodontics | 1223P0700X | 14004 | Massachusetts |
Profile Details
| NPI number | 1295936086 |
|---|---|
| LBN Legal business name | Maryniuk, George A |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 30th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295936086 | NPPES |
| Massachusetts | Other | 14004 | STATE LICENSE |
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