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DR. WALTER MATTHEW MAZZELLA DDS

>> Dentist >> Dental Providers

Registrant NPI Number: 1487990099

Individual Registrant:
DR. WALTER MATTHEW MAZZELLA DDS
Gender: M
Sole Proprietor

Location and contact information for practice:
10775 BIRMINGHAM WAY SUITE 1 WOODSTOCK, MD 21163-1425 US
Tel: 410-203-2552  Fax: --

Contact information for business:
10775 BIRMINGHAM WAY SUITE 1 WOODSTOCK, MD 21163-1425 US
Tel: 410-203-2552  Fax: --

Registration Information:
NPI: 1487990099
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
MD12129

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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