Provider Demographics
NPI:1316002637
Name:MARS, RICK A (DDS)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:A
Last Name:MARS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2797 NE 207TH ST
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1471
Mailing Address - Country:US
Mailing Address - Phone:305-935-2797
Mailing Address - Fax:
Practice Address - Street 1:2797 NE 207TH ST
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1471
Practice Address - Country:US
Practice Address - Phone:305-935-2797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN11641122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist