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General NPI Number Information
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NPI Number | 1801126602
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Entity Type | Organization
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Legal Business Name | MAPLE DENTAL, LLC
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Dates
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Enumeration Date | 12/30/2009
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Last Update Date | 12/30/2009
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Provider Practice Location Address
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Address Line | 2227 MAPLE AVE
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City | ZANESVILLE
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State | OH
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Zip | 43701-2026
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Country | US
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Telephone | 740-452-9200
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Fax | 740-452-9570
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Provider Business Mailing Address
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Address Line | 2227 MAPLE AVE
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City | ZANESVILLE
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State | OH
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Zip | 43701-2026
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Country | US
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Telephone | 740-452-9200
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Fax | 740-452-9570
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Authorized Official
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Title or Position | DENTIST
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Name | DR. EVA B MESZAROS
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Credential | D.D.S.
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Telephone | 740-452-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 13328
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License Number State | OH
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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 | 30023055
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License Number State | OH
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