Provider Demographics
NPI:1811923527
Name:MARET, JAMEELA (DDS)
Entity type:Individual
Prefix:
First Name:JAMEELA
Middle Name:
Last Name:MARET
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 1:709 E GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:CARLTON
Mailing Address - State:OR
Mailing Address - Zip Code:97111-1030
Mailing Address - Country:US
Mailing Address - Phone:856-630-7413
Mailing Address - Fax:
Practice Address - Street 1:510 NE 8TH ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-3910
Practice Address - Country:US
Practice Address - Phone:503-902-5943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD10664122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist