# MAZZOLA DASCOMB P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306107289
- **Authorized official:** DR. ROBERT LOUIS MAZZOLA MD (PRESIDENT)
- **Authorized official phone:** (801) 272-3799

## Contact information

- **Practice address:** 4590 CLEARVIEW ST, HOLLADAY, UT 84117-4504
- **Practice address phone:** (801) 272-3799
- **Mailing address:** 4590 CLEARVIEW ST, HOLLADAY, UT 84117-4504
- **Mailing address phone:** (801) 272-3799

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 5860780-1205 | UT | — |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | 5860780-1205 | UT | — |
| 207RP1001X | Pulmonary Disease Physician | 5860780-8905 | LA | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | 5860780-1205 | UT | Yes |

## Other

- **Enumeration date:** 06/06/2012
- **Last updated:** 06/06/2012