Provider Demographics
NPI:1427107721
Name:G E MAHER LTD
Entity type:Organization
Organization Name:G E MAHER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MAHER
Authorized Official - Suffix:
Authorized Official - Credentials:BS DDS
Authorized Official - Phone:320-634-4543
Mailing Address - Street 1:BOX 174
Mailing Address - Street 2:101 FIRST AVENUE SW
Mailing Address - City:GLENWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:56334
Mailing Address - Country:US
Mailing Address - Phone:320-634-4543
Mailing Address - Fax:320-634-4544
Practice Address - Street 1:101 FIRST AVENUE SW
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:MN
Practice Address - Zip Code:56334
Practice Address - Country:US
Practice Address - Phone:320-634-4543
Practice Address - Fax:320-634-4544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND7325122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty