Provider Demographics
NPI:1760711899
Name:AZIZOGLI, M. AMER (DDS)
Entity Type:Individual
Prefix:DR
First Name:M. AMER
Middle Name:
Last Name:AZIZOGLI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 FRANKLIN AVE
Mailing Address - Street 2:SUITE # 101
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-3819
Mailing Address - Country:US
Mailing Address - Phone:973-284-1011
Mailing Address - Fax:973-284-1264
Practice Address - Street 1:175 FRANKLIN AVE
Practice Address - Street 2:SUITE # 101
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-3819
Practice Address - Country:US
Practice Address - Phone:973-284-1011
Practice Address - Fax:973-284-1264
Is Sole Proprietor?:No
Enumeration Date:2009-12-20
Last Update Date:2009-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01885300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist