Provider Demographics
NPI:1730250184
Name:MAPLE ORTHODONTICS, PLLC
Entity type:Organization
Organization Name:MAPLE ORTHODONTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST, BUSINESS OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURICIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ARGUELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:248-646-9768
Mailing Address - Street 1:4050 W MAPLE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301-3148
Mailing Address - Country:US
Mailing Address - Phone:248-646-9768
Mailing Address - Fax:248-646-4002
Practice Address - Street 1:4050 W MAPLE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48301-3148
Practice Address - Country:US
Practice Address - Phone:248-646-9768
Practice Address - Fax:248-646-4002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010180381223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty