Provider Demographics
NPI:1467406579
Name:VERNE, MARIA CECILIA (DDS)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CECILIA
Last Name:VERNE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20841 JOHNSON ST STE 104
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-1922
Mailing Address - Country:US
Mailing Address - Phone:954-885-5351
Mailing Address - Fax:954-374-8818
Practice Address - Street 1:20841 JOHNSON ST STE 104
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-1922
Practice Address - Country:US
Practice Address - Phone:954-885-5351
Practice Address - Fax:954-374-8818
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN129801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDN012980OtherDENTAL LICENSE