Provider Demographics
NPI:1396477378
Name:DELALEX-NADAL, MARION (DMD)
Entity type:Individual
Prefix:DR
First Name:MARION
Middle Name:
Last Name:DELALEX-NADAL
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 1:1806 N FLAMINGO RD STE 170
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1029
Mailing Address - Country:US
Mailing Address - Phone:954-437-2040
Mailing Address - Fax:
Practice Address - Street 1:1806 N FLAMINGO RD STE 170
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1029
Practice Address - Country:US
Practice Address - Phone:954-437-2040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN272311223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty