Provider Demographics
NPI:1659980902
Name:MAIZES, LAUREN (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:MAIZES
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 1:2189 CLEVELAND STREET
Mailing Address - Street 2:SUITE 252
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-3243
Mailing Address - Country:US
Mailing Address - Phone:727-461-9149
Mailing Address - Fax:727-446-8382
Practice Address - Street 1:7530 4TH STREET N.
Practice Address - Street 2:
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-5410
Practice Address - Country:US
Practice Address - Phone:727-525-8770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN25152122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist