Provider Demographics
NPI:1396820205
Name:MLADENOVA, TZVETELINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:TZVETELINA
Middle Name:
Last Name:MLADENOVA
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 1:1043 E. MISSOURI AVE.
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014
Mailing Address - Country:US
Mailing Address - Phone:602-216-0100
Mailing Address - Fax:602-216-0200
Practice Address - Street 1:1043 E. MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014
Practice Address - Country:US
Practice Address - Phone:602-216-0100
Practice Address - Fax:602-216-0200
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ59641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice