Provider Demographics
NPI:1265557896
Name:MALTEZOS, CHRISTOS MACK (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOS
Middle Name:MACK
Last Name:MALTEZOS
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 1:3401 SALTERBECK ST.
Mailing Address - Street 2:UNIT 105
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466
Mailing Address - Country:US
Mailing Address - Phone:843-849-1777
Mailing Address - Fax:843-849-2977
Practice Address - Street 1:3401 SALTERBECK ST.
Practice Address - Street 2:UNIT 105
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466
Practice Address - Country:US
Practice Address - Phone:843-849-1777
Practice Address - Fax:843-849-2977
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC41181223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics