Wiltz, Mauricio
Wiltz, Mauricio is an sole proprietor health care provider with primary practice located at 3332 Rochambeau Avenue Department Of Dentistry, 2Nd Floor, Bronx NY 10467-2836. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery is his primary health care specialty. Wiltz, Mauricio can be contacted via phone (718) 920-4984.Contact Information
Primary practice address
3332 Rochambeau Avenue Department Of Dentistry, 2Nd Floor
Bronx NY 10467-2836
Phone: (718) 920-4984
Fax: (718) 515-5419
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 043995 | New York |
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | 043995 | New York |
Profile Details
NPI number | 1760485247 |
---|---|
LBN Legal business name | Wiltz, Mauricio |
Credentials | Doctor of Dental Surgery (DDS) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | May 27th, 2005 |
Last updated | Nov 26th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1760485247 | NPPES |
New York | MEDICAID | 01763744 |
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