Provider Demographics
NPI:1376758268
Name:MOZNER, TIMUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:TIMUR
Middle Name:
Last Name:MOZNER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:TIM
Other - Middle Name:
Other - Last Name:MOZNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS,PC
Mailing Address - Street 1:211 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-1100
Mailing Address - Country:US
Mailing Address - Phone:914-390-9111
Mailing Address - Fax:
Practice Address - Street 1:211 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-1100
Practice Address - Country:US
Practice Address - Phone:914-390-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048393122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist