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NPI Code Detail

MEDICARE: JOHN GAZZERRO DDS INC

MEDICARE: JOHN GAZZERRO DDS INC
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
1122300000XDentist30019308OH

General Provider Information

NPI Number : 1679628549
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHN GAZZERRO DDS INC
Provider Business Mailing Address
First Line : 2545 FAR HILLS AVE
Second Line :
City : DAYTON
State : OH
Zip : 45419-1505
Country : US
Telephone Number : 937-294-6476
Fax Number :
Provider Business Practice Location Address
First Line : 2545 FAR HILLS AVE
Second Line :
City : DAYTON
State : OH
Zip : 45419-1505
Country : US
Telephone Number : 937-294-6476
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOHN W GAZZERRO
Credential : D.D.S.
Telephone Number : 937-294-6476
Provider Enumeration Date : 01/23/2007
Last Update Date : 08/22/2020

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Directions to “JOHN GAZZERRO DDS INC ” Practice Location

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