Individual
DR. THOMAS J MAZZUCKELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, DMD
Contact information
Practice address
11255 PARSONS RD, SUITE 100, DULUTH, GA 30097-1703
(770) 569-1350
(770) 569-1392
Mailing address
11255 PARSONS RD, SUITE 100, DULUTH, GA 30097-1703
(770) 569-1350
(770) 569-1392
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DNO 11417
GA
Other
Enumeration date
12/06/2006
Last updated
10/28/2009
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