Provider Demographics
NPI:1437239894
Name:MAURICE K. MASLIAH, DDS, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MAURICE K. MASLIAH, DDS, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:K
Authorized Official - Last Name:MASLIAH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, ACP
Authorized Official - Phone:310-820-5703
Mailing Address - Street 1:11645 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 1158
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1708
Mailing Address - Country:US
Mailing Address - Phone:310-820-5703
Mailing Address - Fax:310-826-3063
Practice Address - Street 1:11645 WILSHIRE BLVD
Practice Address - Street 2:SUITE 1158
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1708
Practice Address - Country:US
Practice Address - Phone:310-820-5703
Practice Address - Fax:310-826-3063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty