Provider Demographics
NPI:1598927055
Name:MZDENTAL PC
Entity Type:Organization
Organization Name:MZDENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-252-2479
Mailing Address - Street 1:2525 NOSTRAND AVE
Mailing Address - Street 2:SUITE 1P
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4749
Mailing Address - Country:US
Mailing Address - Phone:718-252-2479
Mailing Address - Fax:
Practice Address - Street 1:2525 NOSTRAND AVE
Practice Address - Street 2:SUITE 1P
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-4749
Practice Address - Country:US
Practice Address - Phone:718-252-2479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0463691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty