Provider Demographics
NPI:1992306278
Name:MARIA B MEZZANOTTE DDS LLC
Entity type:Organization
Organization Name:MARIA B MEZZANOTTE DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MEZZNOTTE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, LLC
Authorized Official - Phone:724-658-5883
Mailing Address - Street 1:3409 WILMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-3209
Mailing Address - Country:US
Mailing Address - Phone:724-658-5883
Mailing Address - Fax:724-658-5003
Practice Address - Street 1:3409 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-3209
Practice Address - Country:US
Practice Address - Phone:724-658-5883
Practice Address - Fax:724-658-5003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental