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Individual
DR. MAURICIO WILTZ
Active
Individual
DR. MAURICIO WILTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
043995
NY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
043995
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01763744
—
NY
Enumeration date
05/27/2005
Last updated
11/26/2019
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