Organization
MARLIN FAMILY DENTISTRY
Active
Other names
Marlin Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
VANI PAVAN MS (DENTIST)
(254) 883-3070
Entity
Organization
Contact information
Practice address
110 CHURCH ST, MARLIN, TX 76661-2809
(254) 883-3070
Mailing address
110 CHURCH ST, MARLIN, TX 76661-2809
(254) 883-3070
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053657494
—
TX
Enumeration date
04/25/2019
Last updated
03/17/2020
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