Individual
DR. MICHAEL KENNETH MAZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
601 MILL ST, CRAWFORDSVILLE, IN 47933-3440
(765) 362-5220
(765) 362-6393
Mailing address
601 MILL ST, CRAWFORDSVILLE, IN 47933-3440
(765) 362-5220
(765) 362-6393
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009364
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100185770
—
IN
Enumeration date
10/10/2006
Last updated
11/11/2009
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