Provider Demographics
NPI:1407251010
Name:BORIS ZAK DDS INC
Entity type:Organization
Organization Name:BORIS ZAK DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-683-5300
Mailing Address - Street 1:1425 VIA ANITA
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PLSDS
Mailing Address - State:CA
Mailing Address - Zip Code:90272-2357
Mailing Address - Country:US
Mailing Address - Phone:805-683-5300
Mailing Address - Fax:805-692-5518
Practice Address - Street 1:5168 HOLLISTER AVE
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2526
Practice Address - Country:US
Practice Address - Phone:805-683-5300
Practice Address - Fax:805-692-5518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28828122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty