Provider Demographics
NPI:1528133634
Name:ZYGAR, JEFFREY L (DDS)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:L
Last Name:ZYGAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25995 BARBER CUT OFF RD NE
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:KINGSTON
Mailing Address - State:WA
Mailing Address - Zip Code:98346-8456
Mailing Address - Country:US
Mailing Address - Phone:360-297-2298
Mailing Address - Fax:360-297-8445
Practice Address - Street 1:25995 BARBER CUT OFF RD NE
Practice Address - Street 2:SUITE 2B
Practice Address - City:KINGSTON
Practice Address - State:WA
Practice Address - Zip Code:98346-8456
Practice Address - Country:US
Practice Address - Phone:360-297-2298
Practice Address - Fax:360-297-8445
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA44221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice