Organization
G.MICHAEL MAITRE DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE MICHAEL MAITRE DMD (PRESIDENT)
(251) 344-4571
Entity
Organization
Contact information
Practice address
801 UNIVERSITY BLVD S # A, MOBILE, AL 36609-2923
(251) 344-4571
(251) 344-2413
Mailing address
801 UNIVERSITY BLVD S # A, MOBILE, AL 36609-2923
(251) 344-4571
(251) 344-2413
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2723
AL
1223G0001X
General Practice Dentistry
4529
AL
1223G0001X
General Practice Dentistry
5412
AL
1223G0001X
General Practice Dentistry
5689
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
510-92383
BLUE CROSS BLUE SHILED AL
AL
01
—
510-94272
BLUE CROSS BLUE SHIELD AL
AL
01
—
515-32488
BLUE CROSS BLUE SHIELD AL
AL
Enumeration date
07/11/2006
Last updated
07/09/2009
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