Healthcare Provider Details

I. General information

NPI: 1710770995
Provider Name (Legal Business Name): ZACHARY ALBA MARANA DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E MARTINTOWN RD
NORTH AUGUSTA SC
29841-5303
US

IV. Provider business mailing address

431 ARDEN WAY
EVANS GA
30809-7092
US

V. Phone/Fax

Practice location:
  • Phone: 803-279-4343
  • Fax:
Mailing address:
  • Phone: 706-627-0350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number123890
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number11184
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: