Organization
THOMAS MAZURANIC DDS
Active
Other names
Warrenton Family Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS JOSEPH MAZURANIC DDS (OWNER/DENTIST)
(314) 609-1660
Entity
Organization
Contact information
Practice address
122 E MAIN ST, WARRENTON, MO 63383-2004
(636) 456-4746
Mailing address
17 E GLENWOOD LN, KIRKWOOD, MO 63122-5118
(314) 609-1660
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2013016370
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1801236708
INDIVIDUAL NPI
MO
Enumeration date
05/02/2018
Last updated
05/02/2018
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