Provider Demographics
NPI:1841521168
Name:ZAVORAL, JENNIFER MARIE (DMD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MARIE
Last Name:ZAVORAL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BROOKTREE RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9286
Mailing Address - Country:US
Mailing Address - Phone:724-933-0070
Mailing Address - Fax:
Practice Address - Street 1:1000 BROOKTREE RD
Practice Address - Street 2:SUITE 304
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9286
Practice Address - Country:US
Practice Address - Phone:724-933-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-26
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038111122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist