Provider Demographics
NPI:1215147970
Name:DAVID P MAIER DMD PC
Entity type:Organization
Organization Name:DAVID P MAIER DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PARKE
Authorized Official - Last Name:MAIER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:618-345-1400
Mailing Address - Street 1:1170 BELT LINE RD
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62234-4372
Mailing Address - Country:US
Mailing Address - Phone:618-345-1400
Mailing Address - Fax:
Practice Address - Street 1:1170 BELT LINE RD
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62234-4372
Practice Address - Country:US
Practice Address - Phone:618-345-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental