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General NPI Number Information
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NPI Number | 1629459987
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Entity Type | Individual
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Provider Name | PATRICIA PRIETO MARCHESE DMD
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Gender | Female
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Dates
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Enumeration Date | 06/12/2015
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Last Update Date | 10/03/2016
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Provider Practice Location Address
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Address Line | 5965 RED BUG LAKE RD SUITE 233
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-5080
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Country | US
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Telephone | 407-696-5210
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Fax | 407-696-6488
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Provider Business Mailing Address
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Address Line | 5965 RED BUG LAKE RD SUITE 233
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-5080
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Country | US
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Telephone | 407-696-5210
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Fax | 407-696-6488
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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 | DN21225
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License Number State | FL
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