Provider Demographics
NPI:1548326598
Name:MARQUEZ, ELIZABETH PAULA (DDS)
Entity type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:PAULA
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:PAULA
Other - Last Name:DULCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3636 N FIRST ST
Mailing Address - Street 2:SUITE 152
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-6818
Mailing Address - Country:US
Mailing Address - Phone:559-229-4536
Mailing Address - Fax:559-229-6162
Practice Address - Street 1:3636 N FIRST ST
Practice Address - Street 2:SUITE 152
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-6818
Practice Address - Country:US
Practice Address - Phone:559-229-4536
Practice Address - Fax:559-229-6162
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53831122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist