Provider Demographics
NPI:1083787162
Name:WOZAR, GEOFFREY S (DMD, FAGD)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:S
Last Name:WOZAR
Suffix:
Gender:M
Credentials:DMD, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 S MAIN ST
Mailing Address - Street 2:SUITE 1-S
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-4870
Mailing Address - Country:US
Mailing Address - Phone:215-345-6554
Mailing Address - Fax:215-340-1987
Practice Address - Street 1:301 S MAIN ST
Practice Address - Street 2:SUITE 1-S
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4870
Practice Address - Country:US
Practice Address - Phone:215-345-6554
Practice Address - Fax:215-340-1987
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-031405-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAZEX822OtherBC/BS OF MA
PA001657630OtherUCC
PA2131405PAOtherDELTA DENTAL