Provider Demographics
NPI:1275603649
Name:WEINTRAUB, MAURICE H (DMD)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:H
Last Name:WEINTRAUB
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2070 NORTHBROOK BLVD
Mailing Address - Street 2:STE 12A
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406
Mailing Address - Country:US
Mailing Address - Phone:843-553-7827
Mailing Address - Fax:843-797-2559
Practice Address - Street 1:2070 NORTHBROOK BLVD
Practice Address - Street 2:STE 12A
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406
Practice Address - Country:US
Practice Address - Phone:843-553-7827
Practice Address - Fax:843-797-2559
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20841223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics