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Individual

MARIA MAZZUCCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
200 NW 7TH AVE, FORT LAUDERDALE, FL 33311-9026
(954) 759-6710
(954) 759-6767
Mailing address
1700 NW 49TH ST STE 125, FORT LAUDERDALE, FL 33309-3750
(954) 759-6710
(954) 759-6767

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN15711
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
075557500
FL
01
83355
BCBS
FL
Enumeration date
02/22/2007
Last updated
07/27/2022
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