Mazzawi, Jeffrey Miles
Mazzawi, Jeffrey Miles is an sole proprietor health care provider with primary practice located at 205 Waleska Rd Suite 2-B, Canton GA 30114. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Mazzawi, Jeffrey Miles can be contacted via phone (770) 479-1717.Contact Information
Primary practice address
205 Waleska Rd Suite 2-B
Canton GA 30114
Phone: (770) 479-1717
Fax: (770) 479-1747
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | DN012359 | Georgia |
Profile Details
| NPI number | 1356364665 |
|---|---|
| LBN Legal business name | Mazzawi, Jeffrey Miles |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 26th, 2006 |
| Last updated | Dec 10th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356364665 | NPPES |
| Georgia | MEDICAID | 686404389A |
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