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Organization

MAZZOLA DASCOMB P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT LOUIS MAZZOLA MD (PRESIDENT)
(801) 272-3799
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
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
Primary
5860780-1205
UT

Other

Enumeration date
06/06/2012
Last updated
06/06/2012
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