Individual
DR. EDWARD CRAIG MAZIQUE II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3925 MINNESOTA AVE NE, WASHINGTON, DC 20019-2662
(202) 396-1444
Mailing address
350 N CLARK ST, 6TH FLOOR, CHICAGO, IL 60654-4712
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15695
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2014
Last updated
05/23/2016
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