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Individual

DR. GARY STEVEN MAYNE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS, MS

Contact information

Practice address
4881 SUGAR MAPLE DR, WPAFB, OH 45433-5529
(937) 257-8761
Mailing address
4881 SUGAR MAPLE DR, WPAFB, OH 45433-5529

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DD2706
NM
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DE9885
WA

Other

Enumeration date
12/11/2006
Last updated
06/05/2024
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