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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760485247 NPPES
New York MEDICAID 01763744

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