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General NPI Number Information
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NPI Number | 1639990351
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Entity Type | Organization
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Legal Business Name | MAZZONE DENTISTRY PLLC
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Dates
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Enumeration Date | 10/24/2024
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 847 EASTON RD STE 2600
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City | WARRINGTON
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State | PA
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Zip | 18976-2907
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Country | US
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Telephone | 215-918-5630
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Fax |
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Provider Business Mailing Address
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Address Line | 847 EASTON RD STE 2600
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City | WARRINGTON
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State | PA
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Zip | 18976-2907
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SR CREDENTIALING TEAM LEAD
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Name | JENNY GARCIA-ROCHA
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Credential |
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Telephone | 972-869-3789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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