Provider Demographics
NPI:1588952352
Name:MATURIN, ERIN M (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:M
Last Name:MATURIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14639 AIRLINE HWY STE 111
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-6632
Mailing Address - Country:US
Mailing Address - Phone:225-402-4118
Mailing Address - Fax:
Practice Address - Street 1:9234 N LOOP 1604 W
Practice Address - Street 2:SUITES 121, 123
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-2983
Practice Address - Country:US
Practice Address - Phone:210-521-5430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-14
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX292101223P0221X
LA61621223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry