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NPI Code Detail

MEDICARE: DR. SETH LAWRENCE MALTZ D.D.S.

MEDICARE:  DR. SETH LAWRENCE MALTZ  D.D.S.
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
11223S0112XOral and Maxillofacial Surgery (Dentist)045815NY

General Provider Information

NPI Number : 1104929132
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SETH LAWRENCE MALTZ D.D.S.
Provider Business Mailing Address
First Line : 955 PENNSYLVANIA AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11207-8416
Country : US
Telephone Number : 718-272-8300
Fax Number : 718-272-3978
Provider Business Practice Location Address
First Line : 955 PENNSYLVANIA AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11207-8416
Country : US
Telephone Number : 718-272-8300
Fax Number : 718-272-3978
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2006
Last Update Date : 07/08/2007

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Directions to “ DR. SETH LAWRENCE MALTZ D.D.S.” Practice Location

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