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Organization
CORA A MARSAW DDS PA
Active
Organization
CORA A MARSAW DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CORA A MARSAW D.D.S.,P.A. (PERIODONTIST)
(972) 270-9647
Entity
Organization
Contact information
Practice address
3605 INTERSTATE 30, SUITE B, MESQUITE, TX 75150-2670
(972) 270-9647
(972) 270-9648
Mailing address
3605 I-30 WEST, SUITE -B, MESQUITE, TX 75150
(972) 270-9647
(972) 270-9648
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
015805
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009003
FORTTIS FACILITY ID
TX
05
—
008994801
—
TX
01
—
250578
CIGNA FACILITY ID
TX
01
—
4001092
GUARDIAN PROVIDER NUMBER MESQUITE
TX
01
—
4001093
GUARDIAN PROVIDER NUMBER DVILLE
TX
01
—
405623
UNITED CONCORDIA PROVIDER
TX
01
—
646307
DELTA CARE FACILITY ID
TX
Enumeration date
05/25/2011
Last updated
05/25/2011
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