Individual
BAN AL QAZZAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
30 PINNACLE DR, CLARION, PA 16214-3800
(814) 223-9906
Mailing address
63 PITT ST, SHARON, PA 16146-2102
(814) 223-9914
(814) 223-9917
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS044699
PA
1223D0001X
Public Health Dentistry
DS044699
PA
Other
Enumeration date
06/14/2024
Last updated
09/16/2024
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