Organization · NPI-2

Anna Marie Mazoch, DDS, P.A.

Dentist · Wilmington, DE

NPI number1306115597
StatusActive
Last updated in NPPESDec 19, 2011

Details

NPI
1306115597
Entity type
Organization (NPI-2)
Legal business name
Anna Marie Mazoch, DDS, P.A.
Organization subpart
No
Enumeration date
Dec 19, 2011
Last updated
Dec 19, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X DentistG1-001096DEYes

Practice location

2601 Annand Dr
Suite 18
Wilmington, DE 19808

Phone 302-998-9594 · Fax 302-998-8207

Mailing address

2601 Annand Drive
Suite 18
Wilmington, DE 19808-3719

Phone 302-998-9594 · Fax 302-998-8207

Authorized official

Anna Marie Mazoch
President/Dentist
3029989594

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