Provider Demographics
NPI:1689727067
Name:MARX, RONALD B (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:B
Last Name:MARX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 HOLLYWOOD BLVD.
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-2630
Mailing Address - Country:US
Mailing Address - Phone:954-989-4400
Mailing Address - Fax:
Practice Address - Street 1:5000 HOLLYWOOD BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6530
Practice Address - Country:US
Practice Address - Phone:954-989-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL52131223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry