Provider Demographics
NPI:1821725011
Name:COBZARU, VLAD (DMD)
Entity Type:Individual
Prefix:
First Name:VLAD
Middle Name:
Last Name:COBZARU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 SOUTHERN JUNCTION BLVD STE 701
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-2216
Mailing Address - Country:US
Mailing Address - Phone:912-330-4545
Mailing Address - Fax:
Practice Address - Street 1:723 E 65TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4408
Practice Address - Country:US
Practice Address - Phone:912-355-0555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-07
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11944122300000X
GADN1227611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist