Provider Demographics
NPI:1508913419
Name:GROWNEY, MAURICE R (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:R
Last Name:GROWNEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 ULLOA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1115
Mailing Address - Country:US
Mailing Address - Phone:415-566-8500
Mailing Address - Fax:415-566-1437
Practice Address - Street 1:790 ULLOA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-1115
Practice Address - Country:US
Practice Address - Phone:415-566-8500
Practice Address - Fax:415-566-1437
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice