Provider Demographics
NPI:1699516948
Name:MARTIK, ZACHARY AUSTIN (DMD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:AUSTIN
Last Name:MARTIK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5927 ROUTE 981 STE 1
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-2688
Mailing Address - Country:US
Mailing Address - Phone:724-537-3314
Mailing Address - Fax:724-537-3257
Practice Address - Street 1:5927 ROUTE 981 STE 1
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-2688
Practice Address - Country:US
Practice Address - Phone:724-537-3314
Practice Address - Fax:724-537-3257
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0446471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADS044647OtherSTATE BOARD OF DENTISTRY