Provider Demographics
NPI:1710159348
Name:MAUCERI, THOMAS P (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:P
Last Name:MAUCERI
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 1:226 SEVENTH STREET
Mailing Address - Street 2:SUITE 10
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11552
Mailing Address - Country:US
Mailing Address - Phone:516-746-0445
Mailing Address - Fax:517-745-8388
Practice Address - Street 1:226 SEVENTH STREET
Practice Address - Street 2:SUITE 10
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11552
Practice Address - Country:US
Practice Address - Phone:516-746-0445
Practice Address - Fax:517-745-8388
Is Sole Proprietor?:No
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY378721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice