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NPI Code Detail

MEDICARE: MZM DENTAL GROUP PLLC

MEDICARE: MZM DENTAL GROUP PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043557127
Entity Type Code : Organization
Provider Name (Legal Business Name) : MZM DENTAL GROUP PLLC
Provider Business Mailing Address
First Line : 1985 OCEAN AVE APT 1D
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-6815
Country : US
Telephone Number : 718-376-4200
Fax Number : 718-376-4202
Provider Business Practice Location Address
First Line : 1985 OCEAN AVE APT 1D
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-6815
Country : US
Telephone Number : 718-376-4200
Fax Number : 718-376-4202
Authorized Official
Title or Position : DENTIST
Name : DR. MICHAEL GELFAND
Credential : DDS
Telephone Number : 718-376-4200
Provider Enumeration Date : 01/10/2013
Last Update Date : 01/10/2013

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Directions to “MZM DENTAL GROUP PLLC ” Practice Location

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