Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 045769 | NY |
NPI | 1235221193 |
---|---|
Provider Name | Dr. Christopher John Mozrall |
First Address | Rochester, NY 14624-4154 |
Second Address | Rochester, NY 14624-4154 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 08/07/2007 |