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NPI Code Detail

MEDICARE: DR. RAY A MAIWURM DDS

MEDICARE:  DR. RAY A MAIWURM  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDN6220FL

General Provider Information

NPI Number : 1083692461
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAY A MAIWURM DDS
Provider Business Mailing Address
First Line : 4362 NORTHLAKE BLVD
Second Line : STE 114
City : PALM BEACH GARDENS
State : FL
Zip : 33410-6275
Country : US
Telephone Number : 561-626-3424
Fax Number : 561-626-5909
Provider Business Practice Location Address
First Line : 4362 NORTHLAKE BLVD
Second Line : STE 114
City : PALM BEACH GARDENS
State : FL
Zip : 33410-6275
Country : US
Telephone Number : 561-626-3424
Fax Number : 561-626-5909
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2006
Last Update Date : 07/08/2007

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Directions to “ DR. RAY A MAIWURM DDS” Practice Location

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