Provider Demographics
NPI:1548740103
Name:BRITTON, MARITZA SARA (DMD)
Entity Type:Individual
Prefix:
First Name:MARITZA
Middle Name:SARA
Last Name:BRITTON
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 1:5090 NW 56TH ST
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3774
Mailing Address - Country:US
Mailing Address - Phone:954-830-8323
Mailing Address - Fax:
Practice Address - Street 1:2820 LOUISVILLE AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-6685
Practice Address - Country:US
Practice Address - Phone:318-450-4248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA69081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice