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NPI Code Detail

MEDICARE: MARIE PARISEK DDS

MEDICARE:   MARIE  PARISEK  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry036997CA

General Provider Information

NPI Number : 1336427202
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIE PARISEK DDS
Provider Business Mailing Address
First Line : 1866 W 11TH ST
Second Line :
City : TRACY
State : CA
Zip : 95376-3736
Country : US
Telephone Number : 209-833-9322
Fax Number : 209-833-9307
Provider Business Practice Location Address
First Line : 1866 W 11TH ST
Second Line :
City : TRACY
State : CA
Zip : 95376-3736
Country : US
Telephone Number : 209-833-9322
Fax Number : 209-833-9307
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2011
Last Update Date : 07/26/2011

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Directions to “ MARIE PARISEK DDS” Practice Location

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