Provider Demographics
NPI:1124248257
Name:MARX, MARIA TERESA (DDS)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:TERESA
Last Name:MARX
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:TERESA
Other - Last Name:AUZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:555 BILTMORE WAY #103
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134
Mailing Address - Country:US
Mailing Address - Phone:305-444-8188
Mailing Address - Fax:305-444-8918
Practice Address - Street 1:555 BILTMORE WAY #103
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134
Practice Address - Country:US
Practice Address - Phone:305-444-8188
Practice Address - Fax:305-444-8918
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL128591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice