Provider Demographics
NPI:1194458604
Name:MARA ARNOLD DDS INC
Entity Type:Organization
Organization Name:MARA ARNOLD DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-332-0638
Mailing Address - Street 1:259 E WORKMAN ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-3507
Mailing Address - Country:US
Mailing Address - Phone:626-332-0638
Mailing Address - Fax:626-331-2300
Practice Address - Street 1:259 E WORKMAN ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-3507
Practice Address - Country:US
Practice Address - Phone:626-332-0638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-03
Last Update Date:2022-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty