MEDICARE: MICHAEL G. MAUCK, D.M.D., P.A.

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
1	1223P0106X	Oral and Maxillofacial Pathology Dentistry	DN9881	FL

General Provider Information

NPI Number	:	1851654677
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL G. MAUCK, D.M.D., P.A.

Provider Business Mailing Address
First Line	:	1051 S STATE ROAD 7 STE 1
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-6135
Country	:	US
Telephone Number	:	561-790-0206
Fax Number	:	561-795-5445

Provider Business Practice Location Address
First Line	:	1051 S STATE ROAD 7 STE 1
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-6135
Country	:	US
Telephone Number	:	561-790-0206
Fax Number	:	561-795-5445

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MICHAEL G MAUCK
Credential	:	DMD
Telephone Number	:	561-790-0206

Provider Enumeration Date	:	06/18/2012
Last Update Date	:	09/11/2025

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