Provider Demographics
NPI:1568591600
Name:DRS. MAZZETTI'S OFFICE
Entity Type:Organization
Organization Name:DRS. MAZZETTI'S OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MAZZETTI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:650-327-1530
Mailing Address - Street 1:2235 ALMA ST
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-3905
Mailing Address - Country:US
Mailing Address - Phone:650-327-1530
Mailing Address - Fax:650-327-6950
Practice Address - Street 1:2235 ALMA ST
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-3905
Practice Address - Country:US
Practice Address - Phone:650-327-1530
Practice Address - Fax:650-327-6950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA414771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty