Healthcare Provider Details

I. General information

NPI: 1215056973
Provider Name (Legal Business Name): MARIELENA ARROYO-PRATT D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7834 FOREST HILL AVE STE 2
RICHMOND VA
23225-1974
US

IV. Provider business mailing address

5117 DORIN HILL CT
GLEN ALLEN VA
23059-5536
US

V. Phone/Fax

Practice location:
  • Phone: 804-740-4330
  • Fax:
Mailing address:
  • Phone: 804-740-4330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number0401008725
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: