Provider Demographics
NPI:1992010128
Name:ALVARO MAYA, DMD, PC
Entity Type:Organization
Organization Name:ALVARO MAYA, DMD, PC
Other - Org Name:EMERSON DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-399-0017
Mailing Address - Street 1:133 LITTLETON RD STE 203
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-3198
Mailing Address - Country:US
Mailing Address - Phone:978-399-0017
Mailing Address - Fax:978-399-0018
Practice Address - Street 1:133 LITTLETON RD STE 203
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3198
Practice Address - Country:US
Practice Address - Phone:978-399-0017
Practice Address - Fax:978-399-0018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA187451223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty