Provider Demographics
NPI:1740786953
Name:SZPARA-JEZIORO, ANN M (RDH)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:M
Last Name:SZPARA-JEZIORO
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MURRAY HILL DR RM 140
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:NY
Mailing Address - Zip Code:14510-1153
Mailing Address - Country:US
Mailing Address - Phone:585-243-7840
Mailing Address - Fax:585-243-7841
Practice Address - Street 1:1 MURRAY HILL DR RM 140
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:NY
Practice Address - Zip Code:14510-1153
Practice Address - Country:US
Practice Address - Phone:585-243-7840
Practice Address - Fax:585-243-7841
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023106124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty