Provider Demographics
NPI:1407236052
Name:YANES, MARNIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARNIE
Middle Name:
Last Name:YANES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17301 NW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-4001
Mailing Address - Country:US
Mailing Address - Phone:305-624-1371
Mailing Address - Fax:305-521-1375
Practice Address - Street 1:17301 NW 27TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-4001
Practice Address - Country:US
Practice Address - Phone:305-624-1371
Practice Address - Fax:305-521-1375
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN21238122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist