| Walter M. Mazzella, D.d.s., P.c. | |
|
10775 Birmingham Way Suite 1 Woodstock MD 21163-1425 | |
| (410) 203-2552 | |
| (410) 203-2546 |
| Full Name | Walter M. Mazzella, D.d.s., P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10775 Birmingham Way, Woodstock, Maryland |
| Authorized Official Name and Position | Walter Matthew Mazzella (PRESIDENT CEO) |
| Authorized Official Contact | 4102032552 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Walter M. Mazzella, D.d.s., P.c. 10775 Birmingham Way Suite 1 Woodstock MD 21163-1425 Ph: (410) 203-2552 | Walter M. Mazzella, D.d.s., P.c. 10775 Birmingham Way Suite 1 Woodstock MD 21163-1425 Ph: (410) 203-2552 |
| NPI Number | 1881787513 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 08/20/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881787513 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12129 (Maryland) | Primary |
Woodstock Family Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10741 Birmingham Way, Woodstock, MD 21163 Phone: 410-750-7855 |