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General NPI Number Information
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NPI Number | 1922406800
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Entity Type | Organization
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Legal Business Name | JAIME R. MARQUEZ D.D.S., P.A.
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Dates
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Enumeration Date | 12/09/2014
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Last Update Date | 12/09/2014
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Provider Practice Location Address
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Address Line | 7301A W PALMETTO PARK RD SUITE 204-A
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City | BOCA RATON
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State | FL
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Zip | 33433-3409
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Country | US
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Telephone | 561-990-9359
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Fax | 561-391-2944
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Provider Business Mailing Address
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Address Line | 7301A W PALMETTO PARK RD SUITE 204-A
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City | BOCA RATON
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State | FL
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Zip | 33433-3409
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Country | US
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Telephone | 561-990-9359
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Fax | 561-391-2944
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JAIME RICK MARQUEZ
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Credential | D.D.S.
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Telephone | 561-990-9353
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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 |
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License Number State |
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