Provider Demographics
NPI:1528035615
Name:RAMOS, MARLENE (DMD)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:
Last Name:RAMOS
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 1:8340 FM 78 STE 8
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-1080
Mailing Address - Country:US
Mailing Address - Phone:787-505-4011
Mailing Address - Fax:210-305-5740
Practice Address - Street 1:8340 FM 78 # 8
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-1080
Practice Address - Country:US
Practice Address - Phone:210-305-5770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2663122300000X
TX25622122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist