Provider Demographics
NPI:1891928800
Name:OZA, MANSI R (DMD)
Entity Type:Individual
Prefix:DR
First Name:MANSI
Middle Name:R
Last Name:OZA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18870 BENT WILLOW CIR
Mailing Address - Street 2:#1114
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-5349
Mailing Address - Country:US
Mailing Address - Phone:215-429-5885
Mailing Address - Fax:
Practice Address - Street 1:18870 BENT WILLOW CIR
Practice Address - Street 2:#1114
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-5349
Practice Address - Country:US
Practice Address - Phone:215-429-5885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD146111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice