Provider Demographics
NPI:1215617766
Name:MARLETT, DANIELLE JO (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:JO
Last Name:MARLETT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:JO
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8609 76TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-7885
Mailing Address - Country:US
Mailing Address - Phone:425-350-2007
Mailing Address - Fax:
Practice Address - Street 1:22905 56TH AVE W STE 101
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-3925
Practice Address - Country:US
Practice Address - Phone:425-776-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE614583341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice