Provider Demographics
NPI:1003083833
Name:MAZIKAS&BARCLAY
Entity Type:Organization
Organization Name:MAZIKAS&BARCLAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:MAZIKAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-823-1005
Mailing Address - Street 1:660 KENILWORTH DR STE 205
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2354
Mailing Address - Country:US
Mailing Address - Phone:410-823-1005
Mailing Address - Fax:410-825-2219
Practice Address - Street 1:660 KENILWORTH DR STE 205
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2354
Practice Address - Country:US
Practice Address - Phone:410-823-1005
Practice Address - Fax:410-825-2219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD40511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty