Provider Demographics
NPI:1447704382
Name:DENNIS VAN MAREN, DDS, PLLC
Entity type:Organization
Organization Name:DENNIS VAN MAREN, DDS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN MAREN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:361-857-6200
Mailing Address - Street 1:5733 SPID DR
Mailing Address - Street 2:STE A
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-3918
Mailing Address - Country:US
Mailing Address - Phone:361-857-6200
Mailing Address - Fax:
Practice Address - Street 1:5733 SPID DR
Practice Address - Street 2:STE A
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-3918
Practice Address - Country:US
Practice Address - Phone:361-857-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27515261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental