Provider Demographics
NPI:1568973246
Name:MARIANNA ZADOV P.A.
Entity Type:Organization
Organization Name:MARIANNA ZADOV P.A.
Other - Org Name:POLO DENTAL OF NAPLES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZADOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-305-2958
Mailing Address - Street 1:4280 TAMIAMI TRL E STE 201
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-6701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4280 TAMIAMI TRL E STE 201
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-6701
Practice Address - Country:US
Practice Address - Phone:561-241-7656
Practice Address - Fax:561-948-2081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-20
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty