Organization
WALTER M. MAZZELLA, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER MATTHEW MAZZELLA D.D.S. (PRESIDENT CEO)
(410) 203-2552
Entity
Organization
Contact information
Practice address
10775 BIRMINGHAM WAY, SUITE 1, WOODSTOCK, MD 21163-1425
(410) 203-2552
(410) 203-2546
Mailing address
10775 BIRMINGHAM WAY, SUITE 1, WOODSTOCK, MD 21163-1425
(410) 203-2552
(410) 203-2546
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12129
MD
Other
Enumeration date
10/02/2006
Last updated
08/20/2007
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