Provider Demographics
NPI:1942637871
Name:SIMOCA, MARIANA (DMD)
Entity type:Individual
Prefix:DR
First Name:MARIANA
Middle Name:
Last Name:SIMOCA
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 1:1880 N CONGRESS AVE STE 335
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8677
Mailing Address - Country:US
Mailing Address - Phone:561-375-8911
Mailing Address - Fax:
Practice Address - Street 1:1880 N CONGRESS AVE STE 335
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8677
Practice Address - Country:US
Practice Address - Phone:561-375-8911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-10
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN250281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice