Individual
SUSAN M MAURER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
3020 HAPPY LANDING DR, SPRINGFIELD, IL 62711-6259
(217) 546-9166
(217) 546-7804
Mailing address
3020 HAPPY LANDING DR, SPRINGFIELD, IL 62711-6259
(217) 546-9166
(217) 546-7804
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002880
—
IL
Enumeration date
12/20/2006
Last updated
07/08/2007
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