Marshall Darien Moini | Davie, FL • PECOS Search

Marshall Darien Moini

Dentist

Dental Providers

3301 College Ave, Davie, FL 33314-7721

(800) 541-6682 (413) 847-1578

PECOS Enrollment

Based on the most recent information from CMS, provider Marshall Darien Moini does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 10:37 AM.

Profile Details

Provider ID
1437700937
Provider Type
Individual
Full Name
Moini, Marshall Darien
Title
Dr.
Credential
DMD

Gender
Male
Sole Proprietor
Yes
Enumeration Date
9/25/2019
Last Updated
9/25/2019

Contact Information

Practice Location

3301 College Ave, Davie, FL 33314-7721

Unlisted Fax

Mailing Location

7200 SW 20th St, Plantation, FL 33317-5017

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1223G0001X Primary	Description Dentist Dental Providers	License DN24529 Florida