Provider Demographics
NPI:1861508517
Name:ROMERO, MARIBEL (DMD)
Entity Type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:ROMERO
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 1:111 WEST MARKET ST
Mailing Address - Street 2:
Mailing Address - City:ORWIGSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17961
Mailing Address - Country:US
Mailing Address - Phone:570-366-2982
Mailing Address - Fax:570-366-2969
Practice Address - Street 1:111 WEST MARKET ST
Practice Address - Street 2:
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961
Practice Address - Country:US
Practice Address - Phone:570-366-2982
Practice Address - Fax:570-366-2969
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029762L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist