Provider Demographics
NPI:1558582841
Name:MARIANNE L BARAN DDS PC
Entity Type:Organization
Organization Name:MARIANNE L BARAN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BARAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PC
Authorized Official - Phone:313-274-5210
Mailing Address - Street 1:23100 CHERRYHILL RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-1493
Mailing Address - Country:US
Mailing Address - Phone:313-274-5210
Mailing Address - Fax:313-274-1246
Practice Address - Street 1:23100 CHERRYHILL RD
Practice Address - Street 2:SUITE 1
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-1493
Practice Address - Country:US
Practice Address - Phone:313-274-5210
Practice Address - Fax:313-274-1246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1958214870OtherBLUE CROSS