Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 21147 | MA |
NPI | 1003956541 |
---|---|
Provider Name | Dr. Maria G Marquez |
First Address | Watertown, MA 02472-3968 |
Second Address | Watertown, MA 02472-3968 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 08/07/2007 |