Provider Demographics
NPI:1164576013
Name:MARRON, IRENE (DMD,MS)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:
Last Name:MARRON
Suffix:
Gender:F
Credentials:DMD,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 NW 70TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2358
Mailing Address - Country:US
Mailing Address - Phone:954-791-7530
Mailing Address - Fax:954-791-7146
Practice Address - Street 1:333 NW 70TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2358
Practice Address - Country:US
Practice Address - Phone:954-791-7530
Practice Address - Fax:954-791-7146
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 163891223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics