Individual
DR. GEORGE MICHAEL MAITRE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
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
4529
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
510-92383
BLUE CROSS BLUE SHIELD AL
AL
01
—
677496
UNITED CONCORDIA
—
Enumeration date
01/03/2008
Last updated
01/03/2008
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