Individual
DR. DOMINIC MOREL-MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
15340 S JOG RD STE 100, DELRAY BEACH, FL 33446-2170
(561) 495-2099
Mailing address
5720 FOX HOLLOW DR APT C, BOCA RATON, FL 33486-8928
(917) 703-8220
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2018010876
MO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN 21761
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN21761
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/06/2011
Last updated
03/07/2025
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