Provider Demographics
NPI:1497968697
Name:PEAROSE, MARYAM MICHELLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARYAM
Middle Name:MICHELLE
Last Name:PEAROSE
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Gender:F
Credentials:DDS
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Mailing Address - Street 1:26730 TOWNE CENTRE DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-2842
Mailing Address - Country:US
Mailing Address - Phone:949-716-2800
Mailing Address - Fax:949-716-2900
Practice Address - Street 1:26730 TOWNE CENTRE DR
Practice Address - Street 2:SUITE 106
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2842
Practice Address - Country:US
Practice Address - Phone:949-716-2800
Practice Address - Fax:949-716-2900
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2011-04-05
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Provider Licenses
StateLicense IDTaxonomies
CA515081223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry