Provider Demographics
NPI:1932207156
Name:ZARATE, ANTONIO BESERRA (DDS)
Entity type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:BESERRA
Last Name:ZARATE
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 1:1225 TRAVIS BLVD
Mailing Address - Street 2:STE. B
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-4892
Mailing Address - Country:US
Mailing Address - Phone:707-425-0225
Mailing Address - Fax:707-425-0247
Practice Address - Street 1:1225 TRAVIS BLVD
Practice Address - Street 2:STE. B
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-4892
Practice Address - Country:US
Practice Address - Phone:707-425-0225
Practice Address - Fax:707-425-0247
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA285071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice