Organization
PERIODONTAL ARTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMAD ELAZIZI BDS, MS (OWNER)
(810) 624-9432
Entity
Organization
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
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
01/26/2022
Last updated
01/26/2022
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