Provider Demographics
NPI:1841743937
Name:ZACHARIAS J KALARICKAL D D S P A
Entity type:Organization
Organization Name:ZACHARIAS J KALARICKAL D D S P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZACHARIAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KALARICKAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-991-5100
Mailing Address - Street 1:28965 WESLEY CHAPEL BLVD
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-3218
Mailing Address - Country:US
Mailing Address - Phone:813-991-5100
Mailing Address - Fax:
Practice Address - Street 1:28965 WESLEY CHAPEL BLVD
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-3218
Practice Address - Country:US
Practice Address - Phone:813-991-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-26
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty