Provider Demographics
NPI:1407477045
Name:DR MAFFEO AND ASSOCIATES PC
Entity Type:Organization
Organization Name:DR MAFFEO AND ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAFFEO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-870-5165
Mailing Address - Street 1:848 N RAINBOW BLVD # 3837
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-1103
Mailing Address - Country:US
Mailing Address - Phone:702-870-5165
Mailing Address - Fax:702-870-3096
Practice Address - Street 1:2701 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102
Practice Address - Country:US
Practice Address - Phone:702-870-5165
Practice Address - Fax:702-870-3096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-06
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty