Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 045815 | NY |
NPI | 1104929132 |
---|---|
Provider Name | Dr. Seth Lawrence Maltz |
First Address | Brooklyn, NY 11207-8416 |
Second Address | Brooklyn, NY 11207-8416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 08/07/2007 |