Individual
DR. WALTER MATTHEW MAZZELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10775 BIRMINGHAM WAY, SUITE 1, WOODSTOCK, MD 21163-1425
(410) 203-2552
Mailing address
10775 BIRMINGHAM WAY, SUITE 1, WOODSTOCK, MD 21163-1425
(410) 203-2552
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12129
MD
Other
Enumeration date
12/31/2012
Last updated
12/31/2012
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