Provider Demographics
NPI:1841292992
Name:ZWACK, WILLIAM E (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:E
Last Name:ZWACK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:68 THOMAS JOHNSON DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:FREDENCH
Mailing Address - State:MD
Mailing Address - Zip Code:21702
Mailing Address - Country:US
Mailing Address - Phone:301-694-2300
Mailing Address - Fax:301-694-7372
Practice Address - Street 1:68 THOMAS JOHNSON DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:FREDENCH
Practice Address - State:MD
Practice Address - Zip Code:21702
Practice Address - Country:US
Practice Address - Phone:301-694-2300
Practice Address - Fax:301-694-7372
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD131781223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU99955Medicare UPIN