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General NPI Number Information
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NPI Number | 1326405929
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Entity Type | Individual
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Provider Name | MARYAM DANYALI
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Gender | Female
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Dates
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Enumeration Date | 01/27/2016
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Last Update Date | 02/09/2016
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Provider Practice Location Address
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Address Line | 3960 COBBLESTONE CT
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City | PLANO
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State | TX
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Zip | 75093-7237
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Country | US
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Telephone | 469-471-4291
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Fax |
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Provider Business Mailing Address
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Address Line | 3960 COBBLESTONE CT
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City | PLANO
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State | TX
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Zip | 75093-7237
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Country | US
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Telephone | 469-471-4291
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 31673
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License Number State | TX
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