Provider Demographics
NPI:1184843385
Name:MAURO, WILLIAM GREGORY (DMD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:GREGORY
Last Name:MAURO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 DARBY RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1475
Mailing Address - Country:US
Mailing Address - Phone:610-644-6858
Mailing Address - Fax:
Practice Address - Street 1:45 DARBY RD
Practice Address - Street 2:SUITE C
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1475
Practice Address - Country:US
Practice Address - Phone:610-644-6858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030213L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice