Provider Demographics
NPI:1942852579
Name:BRIONES, MARYANNE (DMD)
Entity Type:Individual
Prefix:
First Name:MARYANNE
Middle Name:
Last Name:BRIONES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 W ARIZONA PAVILIONS DR APT 9208
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-6824
Mailing Address - Country:US
Mailing Address - Phone:702-810-8103
Mailing Address - Fax:
Practice Address - Street 1:1500 W COMMERCE CT BLDG 3
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85746-6076
Practice Address - Country:US
Practice Address - Phone:702-810-8103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-13
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD010438122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist