Provider Demographics
NPI:1154082568
Name:CHASE, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:CHASE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9102 PORTOFINO PL
Mailing Address - Street 2:
Mailing Address - City:GARDEN RIDGE
Mailing Address - State:TX
Mailing Address - Zip Code:78266-2007
Mailing Address - Country:US
Mailing Address - Phone:210-784-0072
Mailing Address - Fax:
Practice Address - Street 1:9102 PORTOFINO PL
Practice Address - Street 2:
Practice Address - City:GARDEN RIDGE
Practice Address - State:TX
Practice Address - Zip Code:78266-2007
Practice Address - Country:US
Practice Address - Phone:210-784-0072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist