Individual
DR. MOHAMAD ELAZIZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS, MSC
Contact information
Practice address
1281 FLORIDA AVE S, ROCKLEDGE, FL 32955-2439
(321) 632-3171
Mailing address
1281 FLORIDA AVE S, ROCKLEDGE, FL 32955-2439
(321) 632-3171
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2901021068
MI
122300000X
Dentist
DN 20817
FL
1223P0300X
Periodontics
Primary
DN20817
FL
Other
Enumeration date
08/05/2013
Last updated
01/19/2022
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