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General NPI Number Information
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NPI Number | 1538220223
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Entity Type | Individual
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Provider Name | ANTHONY B MAIORANA DDS
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Gender | Male
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 10/29/2012
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Provider Practice Location Address
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Address Line | 1031 WEISS AVE SUITE 201
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-5630
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Country | US
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Telephone | 910-689-1475
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Fax | 910-323-0015
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Provider Business Mailing Address
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Address Line | 1031 WEISS AVE SUITE 201
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-5630
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Country | US
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Telephone | 910-689-1475
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Fax | 910-323-0015
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN013653
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 9139
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License Number State | NC
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