Provider Demographics
NPI:1477660546
Name:MAZ, SHERRY (DMD)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:
Last Name:MAZ
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 1:330 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430
Mailing Address - Country:US
Mailing Address - Phone:201-887-6949
Mailing Address - Fax:201-977-2550
Practice Address - Street 1:330 RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:MAHWAH
Practice Address - State:NJ
Practice Address - Zip Code:07430
Practice Address - Country:US
Practice Address - Phone:201-818-4500
Practice Address - Fax:201-818-4507
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI2109081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice