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General NPI Number Information
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NPI Number | 1801339411
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Entity Type | Organization
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Legal Business Name | MARIANNA ZADOV, P.A
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Dates
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Enumeration Date | 11/30/2016
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 1301 N CONGRESS AVE #110
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City | BOYTON BEACH
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State | FL
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Zip | 33426
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Country | US
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Telephone | 561-292-0155
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Fax | 561-948-2081
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Provider Business Mailing Address
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Address Line | 1301 N CONGRESS AVE #110
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City | BOYTON BEACH
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State | FL
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Zip | 33426
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Country | US
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Telephone | 561-666-0155
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Fax | 561-948-2081
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARIANNA ZADOV
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Credential | DDS
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Telephone | 561-292-0155
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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 | DN16481
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License Number State | FL
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