Provider Demographics
NPI:1972142255
Name:MAURO FAMILY DENTISTRY
Entity type:Organization
Organization Name:MAURO FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:MAURO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:484-645-7270
Mailing Address - Street 1:45 DARBY RD STE C
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1475
Mailing Address - Country:US
Mailing Address - Phone:484-645-7270
Mailing Address - Fax:
Practice Address - Street 1:45 DARBY RD STE C
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1475
Practice Address - Country:US
Practice Address - Phone:484-645-7270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty