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General NPI Number Information
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NPI Number | 1194889766
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Entity Type | Organization
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Legal Business Name | MAYMUDMD, RALPHLEWIS,DMD,LILILIN, DMDLLP
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | 160 WINTHROP AVE
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City | LAWRENCE
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State | MA
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Zip | 01843-3840
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Country | US
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Telephone | 978-725-0072
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Fax | 978-725-6699
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Provider Business Mailing Address
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Address Line | 160 WINTHROP AVE
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City | LAWRENCE
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State | MA
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Zip | 01843-3840
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Country | US
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Telephone | 978-725-0072
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Fax | 978-725-6699
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Authorized Official
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Title or Position | OWNER
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Name | DR. MAY MU
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Credential |
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Telephone | 978-725-0072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 17629
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 14926
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License Number State | MA
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