| Alexander Marose | |
|
25542 Jeronimo Rd Ste 3 Mission Viejo CA 92691-2724 | |
| (949) 457-0223 | |
| (949) 588-2766 |
| Full Name | Alexander Marose |
|---|---|
| Speciality | Dentist |
| Location | 25542 Jeronimo Rd Ste 3, Mission Viejo, California |
| Authorized Official Name and Position | Alexander Marose (OWNER) |
| Authorized Official Contact | 9494570223 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alexander Marose 25542 Jeronimo Rd Ste 3 Mission Viejo CA 92691-2724 Ph: (949) 457-0223 | Alexander Marose 25542 Jeronimo Rd Ste 3 Mission Viejo CA 92691-2724 Ph: (949) 457-0223 |
| NPI Number | 1306999818 |
|---|---|
| Provider Enumeration Date | 01/19/2007 |
| Last Update Date | 11/01/2020 |
| Medicare PECOS PAC ID | 9537404694 |
|---|---|
| Medicare Enrollment ID | O20181218000363 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306999818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 35490 (California) | Primary |
| Provider Name | Alexander V Marose |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1083966972 PECOS PAC ID: 1052656113 Enrollment ID: I20181218003140 |
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