Provider Demographics
NPI:1356433676
Name:MARRANDINO, CAROL L (DDS)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:L
Last Name:MARRANDINO
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 1:2701 W CHARLESTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2154
Mailing Address - Country:US
Mailing Address - Phone:702-870-5165
Mailing Address - Fax:702-870-3096
Practice Address - Street 1:2701 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2154
Practice Address - Country:US
Practice Address - Phone:702-870-5165
Practice Address - Fax:702-870-3096
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2513122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist