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Individual
MATTHEW L ZIZMOR
Active
Individual
MATTHEW L ZIZMOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
13781
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X05193
BLUE CROSS BLUE SHIELD
MA
Enumeration date
02/14/2008
Last updated
06/30/2014
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