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General NPI Number Information
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NPI Number | 1659496610
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Entity Type | Organization
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Legal Business Name | GORDON & MALTZ P.C.
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 07/26/2007
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Provider Practice Location Address
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Address Line | 19 SQUADRON BLVD
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City | NEW CITY
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State | NY
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Zip | 10956-5227
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Country | US
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Telephone | 845-634-8807
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Fax | 845-639-0477
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Provider Business Mailing Address
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Address Line | 19 SQUADRON BLVD.
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City | NEW CITY
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State | NY
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Zip | 10956-5227
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Country | US
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Telephone | 845-634-8807
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Fax | 845-639-0477
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Authorized Official
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Title or Position | PARTNER
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Name | DR. MICHAEL L. MALTZ
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Credential | D.M.D.
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Telephone | 845-634-8807
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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 |
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License Number State |
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