Provider Demographics
NPI:1609181577
Name:MA, NANCY Z (DDS)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:Z
Last Name:MA
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 1:80 BOWERY RM 502
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4668
Mailing Address - Country:US
Mailing Address - Phone:212-925-2532
Mailing Address - Fax:212-925-2542
Practice Address - Street 1:80 BOWERY RM 502
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4668
Practice Address - Country:US
Practice Address - Phone:212-925-2532
Practice Address - Fax:212-925-2542
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055077122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist