Provider Demographics
NPI:1730481698
Name:MICHAEL MARURI DMD PA
Entity Type:Organization
Organization Name:MICHAEL MARURI DMD PA
Other - Org Name:SUPER SMILES KIDS DENTAL & ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT /OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:STEVE
Authorized Official - Last Name:MARURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-473-6901
Mailing Address - Street 1:10189 CLEARY BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1027
Mailing Address - Country:US
Mailing Address - Phone:954-473-6901
Mailing Address - Fax:
Practice Address - Street 1:815 S UNIVERSITY DR STE 100
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3312
Practice Address - Country:US
Practice Address - Phone:954-473-6900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-29
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18464261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental