Provider Demographics
NPI:1740230499
Name:MAULTSBY-BROWN, DENISE RENEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:RENEE
Last Name:MAULTSBY-BROWN
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 1:10903 WACO DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-4677
Mailing Address - Country:US
Mailing Address - Phone:301-868-3817
Mailing Address - Fax:
Practice Address - Street 1:10903 WACO DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-4677
Practice Address - Country:US
Practice Address - Phone:301-868-3817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD135061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice