Provider Demographics
NPI:1790772648
Name:MARAVI, FERNANDO APOLINARIO (DDS)
Entity Type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:APOLINARIO
Last Name:MARAVI
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 1:900 17TH ST S
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-2602
Mailing Address - Country:US
Mailing Address - Phone:610-299-1673
Mailing Address - Fax:
Practice Address - Street 1:900 17TH ST S
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-2602
Practice Address - Country:US
Practice Address - Phone:610-299-1673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045608-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist