Provider Demographics
NPI:1215332937
Name:ZBARASCHUHK DENTAL CARE
Entity type:Organization
Organization Name:ZBARASCHUHK DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:E
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:ZBARASCHUK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-683-3626
Mailing Address - Street 1:645 N 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-3001
Mailing Address - Country:US
Mailing Address - Phone:360-683-3626
Mailing Address - Fax:260-683-2384
Practice Address - Street 1:645 N 5TH AVE
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3001
Practice Address - Country:US
Practice Address - Phone:360-683-3626
Practice Address - Fax:260-683-2384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 00006446122300000X
WADH 00007840124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Single Specialty