Provider Demographics
NPI:1497287718
Name:BOTROS, MARIA (DDS)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:BOTROS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8094 ASTER CT
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45044-1235
Mailing Address - Country:US
Mailing Address - Phone:513-484-1149
Mailing Address - Fax:
Practice Address - Street 1:1239 STATE ROAD 229
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-6804
Practice Address - Country:US
Practice Address - Phone:812-934-6166
Practice Address - Fax:812-933-0129
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12013225A1223P0221X
OH30.0253301223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry