Provider Demographics
NPI:1972386720
Name:KAZMI, GHAZIA A (DDS)
Entity Type:Individual
Prefix:DR
First Name:GHAZIA
Middle Name:A
Last Name:KAZMI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5813 MEDINA DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-6247
Mailing Address - Country:US
Mailing Address - Phone:254-350-9183
Mailing Address - Fax:
Practice Address - Street 1:3300 E CENTRAL TEXAS EXPY STE 302
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-5674
Practice Address - Country:US
Practice Address - Phone:254-699-6799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39901122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist