Marcinak, C Fred

Marcinak, C Fred is an individual health care provider with primary practice located at 102 Lusk Dr , West Union SC 29696-2629. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Marcinak, C Fred can be contacted via phone (864) 638-7733.

Contact Information

Primary practice address
102 Lusk Dr West Union SC 29696-2629
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 2195 South Carolina

Profile Details

NPI number 1396862173
LBN Legal business name Marcinak, C Fred
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2007
Last updated Jul 8th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396862173 NPPES
South Carolina MEDICAID 002195

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