MEDICARE: DR. MARI NORUZI DMD

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
1	1223G0001X	General Practice Dentistry	DI16819	NJ

General Provider Information

NPI Number	:	1861539116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARI NORUZI DMD

Provider Business Mailing Address
First Line	:	205 TRYON PL
Second Line	:
City	:	PARAMUS
State	:	NJ
Zip	:	07652-4213
Country	:	US
Telephone Number	:
Fax Number	:	201-791-0364

Provider Business Practice Location Address
First Line	:	265 CEDAR LN FL 3
Second Line	:
City	:	TEANECK
State	:	NJ
Zip	:	07666-3444
Country	:	US
Telephone Number	:	201-488-1164
Fax Number	:	201-791-0364

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	02/07/2023

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