Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 30-021097 | OH |
N | 1223S0112X | Oral and Maxillofacial Surgeon | 30-021097 | OH |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 30-021097 | OH |
NPI | 1053389965 |
---|---|
Provider Name | Dr. Robert Marciani |
First Address | Cincinnati, OH 45263-0579 |
Second Address | Cincinnati, OH 45219-4231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 26/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0394032 | (05) | OH |
T53927 | (02) | OH |