Individual
MARISSA PASION MANDAP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
846 S STAPLEY DR, MESA, AZ 85204-4243
(480) 834-8405
Mailing address
846 S STAPLEY DR, MESA, AZ 85204-4243
(480) 834-8405
(480) 464-6256
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7325
AZ
Other
Enumeration date
08/15/2007
Last updated
08/15/2007
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