Provider Demographics
NPI:1962555375
Name:ZOVICKIAN, WILLIAM H (DDS)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:ZOVICKIAN
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 1:57 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:CT
Mailing Address - Zip Code:06069-2018
Mailing Address - Country:US
Mailing Address - Phone:860-364-0204
Mailing Address - Fax:
Practice Address - Street 1:57 MAIN ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:CT
Practice Address - Zip Code:06069-2018
Practice Address - Country:US
Practice Address - Phone:860-364-0204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT45481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice