Provider Demographics
NPI:1730208760
Name:AMARAL, MARILYN (DDS,PA)
Entity type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:
Last Name:AMARAL
Suffix:
Gender:F
Credentials:DDS,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8720 N KENDALL DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2299
Mailing Address - Country:US
Mailing Address - Phone:305-274-0425
Mailing Address - Fax:305-274-0451
Practice Address - Street 1:12284 SW 123RD PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5468
Practice Address - Country:US
Practice Address - Phone:305-233-4344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0013654122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist