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Individual

MARICEL CARBONELL MENESES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3624 W BASELINE RD STE 170, LAVEEN, AZ 85339-3044
(602) 825-8420
Mailing address
3624 W BASELINE RD STE 170, LAVEEN, AZ 85339-3044
(602) 825-8420

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
143821
ZZ
126800000X
Dental Assistant
Primary
20230419123217
AZ

Other

Enumeration date
04/28/2025
Last updated
05/27/2025
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