Provider Demographics
NPI:1073645917
Name:PAZMAN, MICHAEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:PAZMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11931 STATE ROUTE 85
Mailing Address - Street 2:SUITE A
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-3741
Mailing Address - Country:US
Mailing Address - Phone:724-545-1700
Mailing Address - Fax:724-543-9144
Practice Address - Street 1:11931 STATE ROUTE 85
Practice Address - Street 2:SUITE A
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-3741
Practice Address - Country:US
Practice Address - Phone:724-545-1700
Practice Address - Fax:724-543-9144
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS031545L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018775500002OtherMEDICAL ASSISTANCE