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NPI Code Detail

MEDICARE: DR. MARILENA PARODI LAINEZ DDS MS

MEDICARE:  DR. MARILENA  PARODI LAINEZ  DDS MS
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
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry37296TX

General Provider Information

NPI Number : 1477123396
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARILENA PARODI LAINEZ DDS MS
Provider Business Mailing Address
First Line : 16333 VANCE JACKSON APT 2230
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78257-5107
Country : US
Telephone Number : 786-763-8411
Fax Number :
Provider Business Practice Location Address
First Line : 9822 POTRANCO RD STE 105
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78251-9608
Country : US
Telephone Number : 786-763-8411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2021
Last Update Date : 07/01/2021

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Directions to “ DR. MARILENA PARODI LAINEZ DDS MS” Practice Location

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