Individual
DR. CHARLIE BRIAN MAIZARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
40041 STETSON AVE, HEMET, CA 92543-7212
(951) 348-1267
Mailing address
40041 STETSON AVE, HEMET, CA 92543-7212
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
112641
CA
126800000X
Dental Assistant
72458
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72458
—
CA
Enumeration date
03/15/2018
Last updated
01/12/2026
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