Provider Demographics
NPI:1740675305
Name:MAHER, MICHELLE FRIEDBERG
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:FRIEDBERG
Last Name:MAHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 PEOPLES PLZ
Mailing Address - Street 2:SUITE 1260
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5701
Mailing Address - Country:US
Mailing Address - Phone:302-834-7700
Mailing Address - Fax:302-834-5325
Practice Address - Street 1:1200 PEOPLES PLZ
Practice Address - Street 2:SUITE 1260
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5701
Practice Address - Country:US
Practice Address - Phone:302-834-7700
Practice Address - Fax:302-834-5325
Is Sole Proprietor?:No
Enumeration Date:2015-03-31
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00013751223D0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223D0001XDental ProvidersDentistDental Public Health