Provider Demographics
NPI:1780316133
Name:MZAM LLC
Entity type:Organization
Organization Name:MZAM LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAKHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-423-2785
Mailing Address - Street 1:9020 RANCHO DEL RIO DR STE 105
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5277
Mailing Address - Country:US
Mailing Address - Phone:615-423-2785
Mailing Address - Fax:
Practice Address - Street 1:9020 RANCHO DEL RIO DR STE 105
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-5277
Practice Address - Country:US
Practice Address - Phone:615-423-2785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty