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General NPI Number Information
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NPI Number | 1366050767
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Entity Type | Individual
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Provider Name | LIANNETTE MARQUEZ DMD
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Gender | Female
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Dates
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Enumeration Date | 07/21/2020
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Last Update Date | 07/21/2020
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Provider Practice Location Address
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Address Line | 8370 W FLAGLER ST STE 100
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City | MIAMI
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State | FL
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Zip | 33144-2038
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Country | US
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Telephone | 786-212-1596
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Fax | 786-212-1740
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Provider Business Mailing Address
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Address Line | 10274 SW 26TH TER
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City | MIAMI
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State | FL
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Zip | 33165-2849
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Country | US
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Telephone | 239-595-7616
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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 | 25254
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License Number State | FL
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