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Individual
DR. WILSON MALDONADO
Active
Individual
DR. WILSON MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15827
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639398316
NATIONAL PROVIDER IDENTIFIER
NJ
Enumeration date
12/29/2014
Last updated
12/29/2014
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