Provider Demographics
NPI:1487206223
Name:SHMURAK, MAYA (DMD)
Entity Type:Individual
Prefix:DR
First Name:MAYA
Middle Name:
Last Name:SHMURAK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 HORIZON DR STE 119
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-4100
Mailing Address - Country:US
Mailing Address - Phone:215-996-9968
Mailing Address - Fax:
Practice Address - Street 1:1600 HORIZON DR STE 119
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-4100
Practice Address - Country:US
Practice Address - Phone:215-996-9968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0423481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice