Provider Demographics
NPI:1194088450
Name:MAZZUOCCOLO, JOHN JAMES (DMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JAMES
Last Name:MAZZUOCCOLO
Suffix:
Gender:M
Credentials:DMD
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Mailing Address - Street 1:ORAL AND MAXILLOFACIAL SURGERY
Mailing Address - Street 2:1395 CENTER DRIVE, D7-6, BOX 100416
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0416
Mailing Address - Country:US
Mailing Address - Phone:352-273-6750
Mailing Address - Fax:352-392-7609
Practice Address - Street 1:ORAL AND MAXILLOFACIAL SURGERY
Practice Address - Street 2:1395 CENTER DRIVE, D7-6, BOX 100416
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0416
Practice Address - Country:US
Practice Address - Phone:352-273-6750
Practice Address - Fax:352-392-7609
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2013-02-12
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Provider Licenses
StateLicense IDTaxonomies
FLDN197441223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery