Provider Demographics
NPI:1700809985
Name:MOZINGO, ANN V (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:V
Last Name:MOZINGO
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 1:240 MATHISTOWN RD
Mailing Address - Street 2:SUITE 214
Mailing Address - City:LITTLE EGG HARBOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-1702
Mailing Address - Country:US
Mailing Address - Phone:609-296-1234
Mailing Address - Fax:609-296-1289
Practice Address - Street 1:240 MATHISTOWN RD
Practice Address - Street 2:SUITE 214
Practice Address - City:LITTLE EGG HARBOR
Practice Address - State:NJ
Practice Address - Zip Code:08087-1702
Practice Address - Country:US
Practice Address - Phone:609-296-1234
Practice Address - Fax:609-296-1289
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI15702122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist