Provider Demographics
NPI:1427120898
Name:MOCZEK, HARRY WILLIAM (DDS)
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:WILLIAM
Last Name:MOCZEK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 QUEENS RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1860
Mailing Address - Country:US
Mailing Address - Phone:704-376-7827
Mailing Address - Fax:
Practice Address - Street 1:1000 QUEENS RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1860
Practice Address - Country:US
Practice Address - Phone:704-376-7827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC43771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice