Provider Demographics
NPI:1346660750
Name:MOZA, ISHA (DMD)
Entity Type:Individual
Prefix:
First Name:ISHA
Middle Name:
Last Name:MOZA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 FARMSTEAD ROAD, APT 1106
Mailing Address - Street 2:NORTH YORK
Mailing Address - City:TORONTO
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:M2L2G1
Mailing Address - Country:CA
Mailing Address - Phone:416-449-1617
Mailing Address - Fax:
Practice Address - Street 1:17 FARMSTEAD ROAD, APT 1106
Practice Address - Street 2:NORTH YORK
Practice Address - City:TORONTO
Practice Address - State:ONTARIO
Practice Address - Zip Code:M2L2G1
Practice Address - Country:CA
Practice Address - Phone:416-449-1617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program