Provider Demographics
NPI:1033314232
Name:ALBOUZ, MAHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAHER
Middle Name:
Last Name:ALBOUZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22062 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1645
Mailing Address - Country:US
Mailing Address - Phone:818-676-1485
Mailing Address - Fax:818-676-1489
Practice Address - Street 1:639 E FOOTHILL BLVD STE A
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-1253
Practice Address - Country:US
Practice Address - Phone:909-599-2029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46013122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist