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General NPI Number Information
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NPI Number | 1992089163
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Entity Type | Individual
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Provider Name | ZYDNIA MICHELLE MARRERO D.M.D
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Gender | Female
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Dates
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Enumeration Date | 10/05/2011
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | 2223 S BUCKNER BLVD
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City | DALLAS
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State | TX
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Zip | 75227-8646
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Country | US
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Telephone | 972-708-4000
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Fax | 972-708-4007
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Provider Business Mailing Address
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Address Line | 12433 WORTHINGTON LN
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City | RHOME
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State | TX
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Zip | 76078-6068
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Country | US
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Telephone | 787-587-6969
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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 | 27463
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License Number State | TX
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