Provider Demographics
NPI:1427331511
Name:ZAMBONI, DAVID (RDH, BS)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:ZAMBONI
Suffix:
Gender:M
Credentials:RDH, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 OGDEN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1910
Mailing Address - Country:US
Mailing Address - Phone:303-863-0772
Mailing Address - Fax:
Practice Address - Street 1:1420 OGDEN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1910
Practice Address - Country:US
Practice Address - Phone:303-863-0772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-24
Last Update Date:2011-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO903763124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist