Provider Demographics
NPI:1881819894
Name:BERNARD MAZA DDS PC
Entity Type:Organization
Organization Name:BERNARD MAZA DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-737-9430
Mailing Address - Street 1:32931 MIDDLEBELT RD
Mailing Address - Street 2:SUITE 612
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334
Mailing Address - Country:US
Mailing Address - Phone:248-737-9430
Mailing Address - Fax:248-851-0843
Practice Address - Street 1:32931 MIDDLEBELT RD
Practice Address - Street 2:SUITE 612
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334
Practice Address - Country:US
Practice Address - Phone:248-737-9430
Practice Address - Fax:248-851-0843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty