Provider Demographics
NPI:1720159809
Name:EDWARDS, MAURICE LUTHER (DMD)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:LUTHER
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:30 EAST 60TH STREET
Mailing Address - Street 2:SUITE 1401
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022
Mailing Address - Country:US
Mailing Address - Phone:212-888-8624
Mailing Address - Fax:212-755-5572
Practice Address - Street 1:30 EAST 60TH STREET
Practice Address - Street 2:1401
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022
Practice Address - Country:US
Practice Address - Phone:212-888-8624
Practice Address - Fax:212-838-5533
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-12
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0463351223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery