Provider Demographics
NPI:1831126150
Name:CONANT, MARIANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIANA
Middle Name:
Last Name:CONANT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11390 E VIA LINDA STE 104
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-4075
Mailing Address - Country:US
Mailing Address - Phone:480-867-1727
Mailing Address - Fax:480-550-6521
Practice Address - Street 1:11390 E VIA LINDA STE 104
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-4075
Practice Address - Country:US
Practice Address - Phone:480-867-1727
Practice Address - Fax:480-550-6521
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0096231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice