Provider Demographics
NPI:1558328591
Name:MAZUJI, NASRIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:NASRIN
Middle Name:
Last Name:MAZUJI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIT 26610
Mailing Address - Street 2:WUERZBURG DENTAL ACTIVITY CREDENTIAL OFFICE
Mailing Address - City:APO AE
Mailing Address - State:NY
Mailing Address - Zip Code:09244
Mailing Address - Country:US
Mailing Address - Phone:931-804-3933
Mailing Address - Fax:
Practice Address - Street 1:UNIT 26610
Practice Address - Street 2:WUERZBURG DENTAL ACTIVITY CREDENTIAL OFFICE
Practice Address - City:APO AE
Practice Address - State:NY
Practice Address - Zip Code:09244
Practice Address - Country:US
Practice Address - Phone:931-804-3933
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI8121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice